Laserfiche WebLink
OCT-23-2015 09',E0 From:14253770Ec9 raee�y•ti <br />��4�i�!lfA�'�� PR1E�4"ENie��d ��il'fG� �I�i�L <br />OP9�TALG�lT7�N �F9�CKLl�T <br />Insta�aBon Company Nema ano Cr�nk �t Info: <br />Date Back�vater Prevenlipn devlce (BWL) eaas Ins�ailed: ��fe this torm rras car�pleted: <br />Ins�allation Property armer Name and Contsct Info; <br />Propatty Address: <br />Pre�insh�llation fnspeciiort ChechlisL <br />AN lfems m,usr ba chedred �Yes'fn ord2r (or a BWD to bs considered fcrinstellation <br />is there a basement w le��el of the house thaf fs at or r,ear zssumed se�roer mzin elevatfon? � Yes ❑ R'o <br />Ara there fiztures in the house io„a(ed betow ihe upsheam sev+er menho:e rim elevation? � Yes ❑ No <br />Is the side se�Nar a�rzeMly UiJPROTECTED from sewer backups (dces not have a HWD I�sklled)7 � Yes ❑ No <br />Site inspeztion Checkllst <br />A1! item8 must be ohacked 'Yes' be(rne inspectfon i, considereo' comple;a <br />Ulas side sewer TV insp:cfed from jxr�kSing to sev�er man? � Yes ❑ No CondrJon: <br />Does side se�ver have at Ieast 1°!o sl�pe from the huliding to sewer main9 RI Ygs ❑ No Desaibe: <br />Fh,ve aN 6uildng seYrer draln conneoNons ro the side se�ver been �dent;fied and lo�ted? � Y� ❑ No <br />Have all proporty sEarm dralnage ca�mecGons to the eid? sewer been identifled and located? �J Yes ❑ No <br />Has properry be�n flveluated for drainage dericlenGes wtith findings cammunicated to pruperfy o�vne�+ [ Yes ❑ Nu <br />Insl�llatlon DBtaifs; <br />What type and brend ai BVdD wes instaHed at this si6s (Ciesn Check B�AN, Grinder �ump, etc.}; G�eGtM Gh l;k <br />VJhere was the device inet�lled (general descrtpti�n, atr�ch map)? �U'k� ti_G��,_bL�T�A�� <br />Was ihere any other sewer or slerm drainage work completed in conjuncdon wfih the BWD wark? la so pleasa describe; _ <br />Installo4on Checkilst: <br />Rre all doamspout3 and site dreinege disconnected frnm u�-ttsam ot th� B'MJ? �] Yes ❑ No Camments: <br />Oo2s BWD position;ng meets minimum sfope reyuirement af >145? � Yea [I No Comments: <br />C2n BWD be puiled out tor ir,spection aRd meintertance aiier loosening thumb screvf� [�] 1'es ❑ No <br />is BWD lockad Jnto the propet posHi 3r,rew tighfened? [� Yes ❑ �'Vo <br />Circfe ihe BtKD Mver irrigatia� ver (kndscape area Yic lozd bearing cover (dtive surface}! access het�h (building) <br />Was propetly ovmer shorm the Inntlop o ei�steped BWD7 ,� Yes ❑ No Commenb� <br />xProparty Ownor's <br />Irrolallere SlAnatu <br />Date: �U" �"����~ <br />��: �v-23 - � � <br />RevisFon: 2 �� 1 fr(day, Septem6or 12, 2014 <br />