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eirfr <br /> BACKWATER VALVE INSPECTION <br /> CHECKLIST <br /> Property Address: Wk30 C-1 ro '.A <br /> BWV inspected by: V.- • 1/1/6cuLte,{ Date BWV was Inspected: : <br /> FC-e c‘A bv`�,�er <br /> ,,;�5 : t talk, IN C=3,4 CA Et- �4zs z.3t 5141/ Ni(0 — <br /> Inspection Checklist Ivl (ea yy,.4,,,..'� <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? Yes E No <br /> Comments: t'-v.a v.c In- b v- E '— <br /> Does BWV positioning meets minimum slope requirement of>1%? E Yes ❑ No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? E Yes ❑ No <br /> Can BWV be secured into 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 ❑ No <br /> Was property owner shown how to inspect and maintain their BWV? — Yes ❑ No <br /> Does this BWV require repair or replacement? E Yes ❑ No <br /> Comments: L--..1cLerv-ti (nQv►2e.:awvte,r- - twllc.id w( `•?•,c<-- 19144 <br /> - 1W bGry[,wt, ►g ,yrs ole() <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23, 2014`' " " <br />