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BACKWATER VALVE NSPECTION <br /> O <br /> CHECKLIST <br /> Property Address: 2321 O,rc/,n i e i4vte____ <br /> 7l <br /> BWV inspected by: L. 6ct fir- Date BWV was Inspected: : 14( 7 y °Y` y' 3cwn. 7 ' <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? Yes ❑ No <br /> Comments: Joy►^--a cy Z � )1.1,c4-1-01 <br /> uc <br /> Does BWV positioning meets minimum slope requirement of>1%? Yes ❑ No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? 6 Yes E No <br /> Can BWV be secured into the proper position? V Yes n 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 ❑ 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: <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23,2014 "` <br />