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t4w- <br /> BACKWATER VALVE INSPECTION <br /> . ,M � } 3 � <br /> CHECKLIST ., <br /> Property Address: 25 2_2 V <br /> BWV inspected by: L• --3-0W Oatioatr Date BWV was Inspected: : 10/ 3 a e 5 3 a f4 <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? t] Yes ❑ No <br /> Comments: La e O.7cc y n c+ed <br /> Does BWV positioning meets minimum slope requirement of>1%? ] Yes ❑ No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? kl Yes E No <br /> Can BWV be secured into the proper position? KYes ❑ No <br /> Where is the valve installed (general description, attach map)? j s'At og li Ii. .Q-' , :�.e: — 3/0" <br /> elm i <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? t Yes n 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 />