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erwiL <br /> iw <br /> rvg-g Ai? BACKWATER VALVE INSPECTION r� lz_ /� -- <br /> S EC1'I®� <br /> CHECKLIST <br /> Property Address: Li 3 I l-i r rwA � v� <br /> BWV inspected by: L • Date BWV was Inspected: : 101 III 4 Z' 30 r,Y. <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? ❑ Yes ❑ No <br /> Comments: <br /> Does BWV positioning meets minimum slope requirement of>1%? E Yes C No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? 7 Yes E No <br /> Can BWV be secured into the proper position? ❑ Yes E 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? 54 Yes ❑ No <br /> Was property owner shown how to inspect and maintain their BWV? n Yes ❑ No <br /> Does this BWV require repair or replacement? ❑ Yes ZNo <br /> Comments: VeAr ,, -- itikoewv - Vwx.s puittYv p Ud1AL. ud\ <br /> 'ear a-S clan Ii/bZ W ID -• <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23, 2014 <br />