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e/%1ILIPA 6/I...A <br /> BACKWATER VALVE INSPECTION <br /> CHECKLIST <br /> Property Address: 9 2:1 Cn.r <br /> BWV inspected by: L L . wJ‘oCc .,�k.e Date BWV was Inspected: : '0/29 9 14-141 <br /> By <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? FA Yes ❑ No <br /> Comments: c(r ..e,pci,i ,-siiisco>7,--,,,g_2-/e,e( <br /> Does BWV positioning meets minimum slope requirement of>1%? cp Yes ❑ No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? k Yes ❑ No <br /> Can BWV be secured into the proper position?\Q Yes ❑ No <br /> Where is the valve installed (general description, attach map)? /‘•1 w cow-ram- ce 10 _ e/Ai v --- <br /> 'q frvi ,p 1:' vW 1,,,s,,,,, <br /> Is the installed BWV considered an 'approved' model by the City of Everett? [ l 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 t(No <br /> Comments: <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday,September 23,2014 <br />