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� BACKWATER VALVE J '•.; PE O <br /> CHECKLIST <br /> Property Address: I %0 2_ \}tr csi n i Avtta_.- <br /> BWV inspected by: L - Date BWV was Inspected: : <br /> T wv c - %,s1-a,,61,42,4 9 r s c c I I ciw�l .13A.Ic, - o sc1,ne.eipt e <br /> 6,,,,wfson L0 hosin. <br /> Inspection Checklist (fttf MAYetajt w tile res)oonc..€. +I/ <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? n Yes No <br /> Comments: <br /> Does BWV positioning meets minimum slope requirement of>1%? — Yes n No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? n Yes n No <br /> Can BWV be secured into the proper position? n Yes No <br /> Where is the valve installed (general description, attach map)? <br /> Is the installed BWV considered an 'approved' model by the City of Everett? Yes n No <br /> Was property owner shown how to inspect and maintain their BWV? Yes I I No <br /> Does this BWV require repair or replacement? n Yes n No <br /> Comments: <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday;September 23, 2014' <br />