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00011.0. <br /> Z'ACKWATER VALVE 0NSPECTION <br /> CHECKLIST <br /> Property Address: 33 f Z Ru-e-- &r vim. <br /> BWV inspected by: J vvi ba1Ae.,'' Date BWV was Inspected: : j0 z� g 3' 3o/40, <br /> C1n P JL -e - 6, s e v4 ,v E .. x cure a - - A/o t3 vv1/ <br /> ��wJ vw door ((fits a l�l� c-6nn tof { ' bast_ <br /> inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? Yes No <br /> Comments: /0,5 o14-— tAec-t--.e <br /> Does BWV positioning meets minimum slope requirement of>1%? ❑ Yes ❑ No <br /> Comments: NA <br /> Can BWV be accessed for inspection and maintenance? (1 Yes n No NA <br /> Can BWV be secured into the proper position? ❑ Yes ❑ No NIA <br /> Where is the valve installed (general description, attach map)? t\ A <br /> Is the installed BWV considered an `approved' model by the City of Everett? g Yes _ No (pil) <br /> Was property owner shown how to inspect and maintain their BWV? (I Yes (1 No <br /> Does this BWV require repair or replacement? Yes ❑ No <br /> Comments: <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23,2014 <br />