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BACKWATER VALVE INSPECTION <br /> CHECKLIST <br /> Property Address: 1 t 1 rcw 14;oc, <br /> BWV inspected by: L. J Date BWV was Inspected: : I Jn41,1 <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? ❑Yes ( No <br /> Comments: '� a �� , �s <br /> Does BWV positioning meets minimum slope requirement of>1%? [l Yes ❑ No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? k Yes E No <br /> Can BWV be secured into the proper position? ( Yes ❑ No <br /> Where is the valve installed(general description, attach map)? � 'v Iv- Ai Caviner 104 <br /> vw a !,we -t ct e,- ea„r p ± <br /> Is the installed BWV considered an 'approved' model by the City of Everett? [gl Yes ❑ No <br /> Was property owner shown how to inspect and maintain their BWV? El Yes E No <br /> Does this BWV require repair or replacement? ❑Yes ENo <br /> Comments: <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23, 2014 <br />