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BACKWATERPREVE11 T1ON 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 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: Q r recrY <br /> Property address: 3 5 3 I lr)Q.-k- 'r-e- <br /> Phone 1: l 25 'v 3 0 - 50(0S Phone 2: <br /> Email: eQ. . tA • rr► QLV\oo. C.O( <br />