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; �„- <br />�� <br />r ,. ' <br />. -{' .� , -� - <br />��� ���� ���������� ����� <br />li������� I1 U�IICI - { � ����� <br />�� ����U�� <br />i�sfaEia�ion Campany i��m�and CDt�tacf Info: I`�OP� ���rL,(�f;,� <br />Date 8acttwa�r F�revenzEon device �BUltf3} was ins�alied: �� � o� ���U �?�t� <br />� �-t —! (, Date this Tarm was campleted: �- - �- � —!C <br />Inszalia�ion Properf}� t�wner Name and Con�ac� 1nTo: L� � �� y�/,.�/ r� <br />Propetty Address: � � a � � ;; 4 h i� � �'j ! ' I �l S � <br />I�r��ir,�;alla�ion i�tspec�o�3 ��eck�fsY: <br />All rfen�s musf be checked `Yes' in ord�r ior a BWD to be cons1dered;orins�allation <br />(s the►'e a basemeni or levef oi the hause fihat is at 4r near assumed sewer main eleva#1an? <br />Ara there fi�fures 1n the riouse lacaied below t�e ups�eam sewer manhofe rim e(eva�ion? �� es � No <br />Is the side sew�r curret�fly U�pROT�CTE9 �ram sev�sr backups (dQ�s not have a BtND ins�ialle� ?❑ �� <br />Si�e Pns����ivn �h��;��sg: ) �Y�,s ❑ No <br />All ;fems musf be checked Yes' bernre inspEcflon ls consirlererl camplefe <br />U1�as sitle sewer N inspec�ed fram buitding fo se�r<<er main? � Y�s ❑ t�o �onc�i�ion. Cl�. , <br />Does side se�uer h�ve ai leasi i°IQ slop� �r�m ��e building fo setiwar main? �� �� <br />�l�ve a€I build'sng sew�r drain c�nnaciians ta fhe side seiver been iden�ned a�Yes ❑ No Descr'tbe: <br />d locate� . � Yes ❑ No <br />Have al! proper'iy szorm drainag� canneciians i� �he side sewer been iden�ed and Ioca��d? (�" Y�s �'] �o <br />Nas praper�J been e�aiva�ed for drainage de��ci�ncies wiFh rir�dings communicated to proper�y ov�mer? (� Yes � f,�o <br />�������LIOI1 �GL'"1el�S: <br />1NhaE {ype. �nd brand of gWp wa� insfafled at r�fs site {Clean Che�k BNN, Grintler purnp, atc.): G��'c:,.� �%.� �,�> <br />41t�here vtras ihe de�►ice #nsialied (generaf descri�`aan, aiiach ma�)? I�l i.�' S' ��-.� vy- <br />!! �u� <br />t�as there any oiher s���er or storm dr 'nage woric eampleted in cori uncfiion wich the BWD work? � <br />� Es so piease de5cribe: <br />�n�x�.ICaiia� �he�%Ils�: � . ____ <br />Are afl downspouts and siie drainage disc4nnected #rom ups�ream of the B1ND? �'j Yes ❑ M�o Commenfs: <br />L�O�S Bi�1D �IOSi�f0l1ii3� �1'IE2fS mlilli3'}Um SI��� �@�U����j'f�q� 0� >� QIo� ���S a�fl �01rii1'iQlliS; <br />Can �IND b� ptrlled oU� fior i�tspe�ion artd mainienance after Ioosening thumb screv�? � Yes ❑ 1�4 � <br />is 8Wp tociced i�t�o �he prQperpasifi_ ion�d Fhumb screw iightened? �j Yes ❑(�o � <br />Circ(e �he BIND cove . rn�aiion co.��1�'tlscape area) /�afFc load bear�ng caver (drive surfaceJ I access haicf� (b�iildinc} <br />�+las �roper'iy awrt�r s��e <br />Iocatton o� the instafled �VUC3? �] y� � 1Vo Gommenis: <br />Pr�perfiy t3wne�'s Sign2#ure: <br />Date: � <br />I�sf�(!er's �ignaiure: � - �'�-�---_ Date; � - � �� — ( � <br />I�Iq <br />R2Vt5�Ot1: Z � <br />Nl�nday, September 1�, ZA1�# <br />