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BACKWATER VALVE INSPECTION <br /> CHECKLIST <br /> Property Address: 2 510 15alzdzr Ave.. <br /> BWV inspected by: f'f ad JItmibct l( Date BWV was Inspected: : IV 6l14 <br /> c I-cc c( — PO p t QC- f t-0 <br /> vt s, 2 Inat.� gW Vs Sid I- l s v i- � <br /> SS tiv es- ext. basewi- 4F da v-e a1—e frAr7 <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? MlC Yes ❑ No <br /> Comments: <br /> Does BWV positioning meets minimum slope requirement of>1%? iz Yes .❑ No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? a Yes ❑ No I ball cLQ cL M f <br /> 1 61•1 V 0-14 noYh1 S7 etc c& <br /> Can BWV be secured into the proper position? 'Yes ❑ No iouvied, am ae""f°ct <br /> Where is the valve installed (general description, attach map)? bk.e. 1e vet t ti f1 buLe> (.4 f- <br /> 1AiV cwt. tryo'h' sic& of <br /> Is the installed BWV considered an `approved' model by the City of Everett? lZ 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 iii No <br /> Comments: Ha) 3` cav,uRchrc— f- of°Tim'N aloha 1-* ca-it't cl- 90A-cam, <br /> vF lctt t jla l.ve _ vtoti 1'1 ea R) Mai'- %.-se v-r Lc I-e <br /> ion)P va-mot 110 Kvv c ri..tr jch <br /> Inspector's Signature: Date: 1 I/ 1 o/f <br /> Revision: 2 Wednesday, November 05, 2014 <br />