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BACKWATER PREVENTION DEVICE PROGRAM <br /> Our records indicate that a backwater prevention device must be installed on your <br /> sewer connection to comply with the new ordinance. Please help us verify that our <br /> information is correct by answering the fplloW)ng questions about your property: <br /> Do you have a basement? Yes yNo <br /> 1 <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes'a No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No D Don't Know <br /> f <br /> Do you have a grinder pump in your basement? Yes X-No ❑ Don't Know ❑ <br /> • <br /> Name: ' <br /> Property address: J f/ - � �`2�' � <br /> Phone 1: hid fT5�D,C.3C3 1 b Phone 2: <br /> �1< y�cc k <br /> Email: . GZ0/• CO,f1 <br /> .`!' <br />