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BACKWATER T VALVE iNSPECTVON <br /> CHECKLIST <br /> Property Address: Lr7 ` LI 0 Ake s <br /> y <br /> BWV inspected by: L• Date BWV was Inspected: : , <br /> P1Rc 3 4,(5 tletw SS was r t.-p/Ac,ed , <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? ► Yes E No <br /> Comments: `[ c 3/D 7� C t Selyttevethi <br /> Does BWV positioning meets minimum slope requirement of>1%? Yes No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? P1 Yes No <br /> Can BWV be secured into the proper position? (I Yes. n No <br /> Where is the valve installed (general description, attach map)? 2-' Id,�- �'Q,,c a� d - 9�kss <br /> c., 4;1 YN a <br /> Is the installed BWV considered an `approved' model by the City of Everett? [ ] Yes 1 No ko coLt,i 3 <br /> Was property owner shown how to inspect and maintain their BWV? Yes n No <br /> Does this BWV require repair or replacement? 7 Yes n No <br /> Comments: Q ave. mew) of i /3 ✓ irp 46 (- <br /> exs <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23, 2.0 4 <br />