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BACKWATER PREVENTION 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 rikNo ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain,etc.)? Yes jk 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 ❑ Nol Don't Know ❑ <br /> Name: , ---'\ I 1 til c <br /> Property address: 10 3 1 C `e '✓ 5�� <br /> Phone 1: 'V( y'3 3 Phone 2: <br /> Email: <br />