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V <br /> BACKWATER VALVE INSPECTION <br /> CHECKLIST <br /> Property Address: 9 3 d U� <br /> BWV inspected by: 0- aukir Date BWV was Inspected: : t(3( l / I q <br /> 1�_ <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? [] Yes ❑ No <br /> Comments: q eiov-,-/eK:7L5 c/i sees-,rt11Lfj <br /> Does BWV positioning meets minimum slope requirement of>1%? ❑ Yes E No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? ❑ Yes [ ] No yye t' l e1lw <br /> Can BWV be secured into the proper position? E Yes ❑ No <br /> Where is the valve installed (general description, attach map)? « e._ 36„ � do, 6' <br /> Is the installed BWV considered an 'approved' model by the City of Everett? [ Yes n 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 ❑ No <br /> Comments: J5 yrs ofi . fi,cvitic 0 /17ht`r <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23, 2014 "" <br />