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BACKWATER VALVE INSPECTION <br /> CHECKLIST <br /> Property Address: 2-3 02 'b J c Ave_ <br /> BWV inspected by: L I��c u�Ps(' Date BWV was Inspected: ; o `-f <br /> (S OtOwv, ill i N 6 S Lit 4+ Ds <br /> IE i z r' <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? [ Yes ❑ No <br /> Comments: c — scrn,0 4. ( <br /> Does BWV positioning meets minimum slope requirement of>1%? ❑ Yes ❑ No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? ❑ Yes ❑ No <br /> Can BWV be secured into the proper position? ❑ Yes ❑ No <br /> Where is the valve installed (general description, attach map)? <br /> Is the installed BWV considered an 'approved' model by the City of Everett? ❑ Yes ❑ No <br /> Was property owner shown how to inspect and maintain their BWV? ❑ Yes ❑ No <br /> Does this BWV require repair or replacement? ❑Yes ❑ No <br /> Comments: <br /> * ho fi UkageSil IA60 <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23,2014 '" <br />