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I <br /> BACKWATER VALVEN J ON <br /> Er'�� L Gam�pp ,®®®®pp �,I <br /> Cl E Fl <br /> Property Address: \ L0 ?3 \. 1 tc3i,k-(' , <br /> BWV inspected by: L' Date BWV was Inspected: : 10(3 liq <br /> pew cs* w) BiAiv srA <br /> rijocioi <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? k Yes No <br /> Comments: S .41)5e r °v, ,oa°4'7' O'l <br /> Does BWV positioning meets minimum slope requirement of>1%? k Yes No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? J Yes n No <br /> Can BWV be secured into the proper position? NQ Yes n No <br /> Where is the valve installed (general description, attach map)? MIA/ 9i 0 OP �a L w -k <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? Yes ( I No <br /> Does this BWV require repair or replacement? I I Yes (tNo <br /> Comments: <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday,September 23, 2014'" <br />