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I <br /> BACKWATER VALVE INSPECTION <br /> 04fg./ CHECKLIST <br /> Property Address: 110 A ra nct Ave— <br /> BWV <br /> BWV inspected by: L• �u.Mctloau Date BWV was Inspected: : i° I I I ILI @_ 12'.N®P m <br /> 1-104- 1,4%11: fe.? ac.c c�uS5 <br /> Inspection Checklist pw� 2 o"us etrl° ( e1,Ooo) <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? (l Yes ❑ No <br /> Comments: pla5t7,c , f¢-( , .m op, <br /> Does BWV positioning meets minimum slope requirement of>1%? E Yes E No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? f] Yes E No <br /> Can BWV be secured+nto 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 E No <br /> Was property owner shown how to inspect and maintain their BWV? ❑ Yes E No <br /> Does this BWV require repair or replacement? E Yes ❑ No <br /> Comments:Qte-- does riot' t i 1r1) rer1 <br /> 11/1 (l1i P1/o&,5 gay- '1 3 f 1-101 ' — 4 /,w R'eS t y' k <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23, 2014 "" <br />