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y <br /> BACKWATER VALVE INSPECTION <br /> CHECKLIST <br /> Property Address: 3 1 21 Oa,(Les A SE <br /> BWV inspected by: L • bct i,„ Date BWV was Inspected: : I<)!l(.„ . 2 '3°p ✓r\ <br /> -p""i' — ,y4,-"A-n,t vA.Iv ^- I ' v -C.)"j .— oAf cs-P � cs,-, g, kv,a i ,,..y <br /> Inspection Checklist I s6. 4. -/- tti r <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? ili Yes ❑ No <br /> Comments: - is spv:r/- I t5_o>;sae{- 4> rr <br /> Does BWV positioning meets minimum slope requirement of>1%? ❑ Yes ❑ No <br /> aA,L---____- <br /> $ <br /> Comments: NAcrY, <br /> Can BWV be accessed for inspection and maintenance? ig Yes ❑ No &e..3-co,,,,o,„,-+ Pc\) i <br /> Can BWV be secured into the proper position? ❑ Yes ❑ No ____1) <br /> Where is the valve installed (general description, attach map)? s.e e af-i-ack.e.a1 <br /> Is the installed BWV considered an `approved' model by the City of Everett? Yes ❑ No <br /> Was property owner shown how to inspect and maintain their BWV? ❑ Yes ❑ No I <br /> Does this BWV require repair or replacement? ❑ Yes f No LV-el_k <br /> Comments: <br /> f t <br /> h <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23, 2014 <br />