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p C4 <br /> BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device must be installed on the sewer <br /> connection at the address identified on the enclosed letter. Please help us verify that our <br /> information is correct by answering the following questions about your property: <br /> Do you have a basement? Yes No ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes N. No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No ❑ Don't Know <br /> Do you have a grinder pump in your basement? Yes ❑ No ❑ Don't Know <br /> Name: <br /> Property address: li,'cc /)t. ' h,J_ -1/ <br /> Phone 145(�J7' l'a�-yob/ Phone 2: <br /> Email: i 7Y1 <br /> '' <br />