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rib.. <br /> , fr/4/1 .-Imitil BACKWATE <br /> R VALVE INSPECTION <br /> Ilte CHECKLIST <br /> Property Address: j//5— /rr.6aa,r-ej Axe_ <br /> BWV inspected by: L- -3—u ioausZ" Date BWV was Inspected: : I l(? e /I Am <br /> 3 W V — access — 2 Ors . oa <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? Yes ❑ No <br /> Comments: S ek)wv\-s)o() * el/5CCIA kte d.ed <br /> Does BWV positioning meets minimum slope requirement of>1%? -4Yes E No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? [ Yes ❑ No <br /> Can BWV be secured into the proper position? 6,Yes _ No <br /> Where is the valve installed (general description, attach map)? I 4 SE sitik a aug._. <br /> '1Ck -t- 2- 1VS- ()id <br /> Is the installed BWV considered an `approved' model by the City of Everett? [I]Yes n No <br /> Was property owner shown how to inspect and maintain their BWV? V Yes n No <br /> Does this BWV require repair or replacement? _ Yes ] No <br /> Comments: _ <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23, 2`0'14' <br />