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i <br /> �A�KWAT�R P'R.�V�NTIQRI Q�4'IC� FIN,C�L <br /> �f* It�S�'l�LLA`�IAN CHEGff�.iS�' <br /> �f?$l"oIIZ(IOfI CC�fi'�,�7d0V N8fT19 Bfid CONBd UiG. �`u ,:�'_�� !"i��G'�•1/.�/r L L�— <br /> rl3ie B2�kV;atar Prevent�on d4\"CB Iv���[�/!C,85 I(15ldl�ed� , Go1^IhlS fOflil 17c5 CCRIaIE�BC: <br /> I <br /> In;ta4a!ion Propert�� Otvner f�ame and Cnntac! Infe. �f` �f —P � V)�� <br /> Prop2rt;Addre;c 1y O I ��CI�'�1� �'U"Q��V�7T� w � �J , � �} � <br /> Pre•Installation Inspection CheCklist: <br /> 411 rrems mu;t b�Checl�ed Ye; ir,o�o�r fo�a 6VJD tc b� CCnsidere;;Jor ms;a!la6or• <br /> Is t;�er;bz;=men��,r i�vel of Ihe hous=lhai�S di Of fE8(a5SUr19C SBwer m�i�'t EIeVZiiIO��� Yg� � hp <br /> �r;�;here (i>;tures in Ihe h�use io:ateu be!o�;;the up;trezm;s��;er manne�e r�m �'r��?tiOA�� YES � �.�0 <br /> is t�=;itie sev!ei currenlW UMPF,OTECTtD irom se�:n_r hackuos (de25 no;have a 9N�D mstalled)� �C7 Ye; [] h!, <br /> Site Mspection Checklist; � <br /> All�tems must bz chech�ed V�s'belore msrection�s:onsiderd comofete � <br /> 11�as s�de:ew�r P!inspecled from bu�id�nu to sev.�er main� �Yr-s ❑ No Co�tlitibn. <br /> Dce; side m,•rer havE Zi ieast �9:,slepQ(tORI lfl� bUil�]if10 lD SBP:ef filal0� �VE; �(�G Coc�riC� <br /> Ha�!r 211 buiiomg se��er drin connections to the sitle se�.ver f�een ider,hfied and lo:z:ed� (�1 Yes ❑ tJo <br /> Hzve;II ureper'q Slorm d;ainage connechon� to lhe si,e see,er b=en identif�etl and �oca��d7 �1'es ❑No <br /> Nas property hGiO evaluated for drair.zo?dencienaes:a�ith findings commwiicated Eo properly ewner? (/�Ye; ❑ h;o <br /> Inst211ation I]etails� <br /> 11�hst lype aod b�znd of 5N;�D�tias installeo at this site(CIe2n Check BIVV Grind=r o��m e�c.) C1 Fc�v� c F��'�-�L <br /> V�'nere tivzs the dev�ce inslalled (oeneral descripuon. aYach map)? jq t,�}��,�e�1�.c:�;S P_ <br /> � <br /> 11'a:Ihere an, other secrer pr storm Arainage erork comol2ted in conjunchon�vilh th=84I�D�:rork? Is so please descri6e. <br /> .�D — <br /> Installatian Ghecklist: <br /> Q.re zil ao:mspouts and sr,e drainage discunnecled from up;tream of the 6UVp� JL�c, Ye ❑IVc Commenls <br /> �aes f3VdD oosdioning meels min�mum slope reqwremeni af >1"!,7 ZLYes ❑ N_ Comn�en,. <br /> Gan 9WD be pulled oul for inspsclion and maintenanr,� 3r;er Iposen�na thumG;cre�:�7 .1'es L N� <br /> Is BS5'D Iccked inlo lhe proper posmqn a �ihumb s�retv fightened? 1S 1'e; [I p!n <br /> Cirde the BN�D co,�er irngatien cov r�landscap—e�1�Uat�ic load heanng cover(ririve surl�ce)1 acCe�s hatCh�huitdingj <br /> :"Jas prope�q�ov:ner sno:vn ,he iocalien cl the inslalled RWD� �Ves ❑ hb Co m=n!s <br /> Pro�eny Ovrner;Signaiure: ��,�'\/� r"l(!"� " �atE �� I.��! �SJ <br /> Sp_��—� I I <br /> !nsr•,Iler's S�gnature ���...�C..Q ` .� CL,` Dat2�. z 1 �7��b <br /> F"�'`'On: ? '. Fridav, S �e?ember 12, 201a <br />