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BACKWATER VALVE INSPECTION <br /> CHECKLIST <br /> Property Address: 5 1-(Q AI v4e v-SCM t?)VA <br /> BWV inspected by: L. \u,y4a.Cl— Date BWV was Inspected: : <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? ❑ Yes [ No <br /> Comments: clio,�.5,p�t4+5 arn•ec-E`eel tic> 5,p~ c(owv-s4.c.G,,„ —, I f c \,/ <br /> Does BWV positioning meets minimum slope requirement of>1%? D� Yes ❑ No <br /> Comments: <br /> r4 <br /> Can BWV be accessed for inspection and maintenance? Yes ❑ No <br /> Can BWV be secured into the proper position? E Yes ❑ No <br /> Where is the valve installed (general description, attach map)? Ir, 10ase E <br /> Is the installed BWV considered an 'approved' model by the City of Everett? M Yes ❑ No <br /> Was property owner shown how to inspect and maintain their BWV? g] Yes ❑ No <br /> Does this BWV require repair or replacement? ❑ Yes No <br /> Comments: <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23, 2014 <br />