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aP <br /> 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 following questions about your property: <br /> Do you have a basement? Yes No ❑ <br /> If yes, does it have plumbing fixtures(sink, toilet,floor drain, etc.)? Yes [ No ❑ <br /> Do you have a backwater valve on your sewer line? Yes ❑ No on't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No [ Qon't Know ❑ <br /> L <br /> Name: b!Q co (R) A 1 <br /> Property address: , r(,Zj f - <br /> Phone 9: — 7l Phone 2: r <br /> Email: <br />