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1 BACKWATER VALVE INSPECTION <br /> CHECKLIST <br /> Property Address: 22-0 Q6 R,, e,( Ar' <br /> BWV inspected by: L • 3 i16aut-ei,r' Date BWV was Inspected: : ►U, I I LI <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? "Yes ❑ No <br /> Comments: � -' ' ) vt eetrd <br /> Does BWV positioning meets minimum slope requirement of>1%? Yes ❑ No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? 14 Yes y o <br /> dui gam. <br /> Can BWV be secured into the proper position? ❑ Yes E No <br /> Where is the valve installed (general description, attach map)? (Jo /1/sYLI WI) 11614.54r <br /> 1,^ 11465 , 5;tie pi7 ppe 4101,44-- &Ai PAWL° AikadleGO <br /> Is the installed BWV considered an `approved' model by the City of Everett? 'Yes E No <br /> Was property owner shown how to inspect and maintain their BWV? ❑ Yes ❑ No <br /> Does this BWV require repair or replacement? ❑ Yes ❑ No <br /> Comments: (2) 13 p/aeid i w 200 - never + <br /> Fjase•m.P.A4 ►S LI / - y- $ ' &Love_ se iv' wvt ar• 22. ",.� <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23, 2'014 " <br />