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BACKWATER SALVE .iq EC O'N <br /> CHECKUST <br /> Property Address: t 00 1,de4vvto,r� <br /> BWV inspected b : L.• Ion \n <br /> p Y � �O Date BWV was Inspected: : 16 e <br /> ors o Let - 041per#- C.-- ' C Via i�) <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? i] Yes I I No <br /> Comments: 14 c.cr.lny_c. p! I coroecTiee ( A)e e_arr, <br /> Does BWV positioning meets minimum slope requirement of>1%? Yes I-1 No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? fXj Yes n No <br /> Can BWV be secured into the proper position? ki Yes No <br /> Where is the valve installed (general description, attach map)? ,.w.., 0, ewp ' <br /> Is the installed BWV considered an 'approved' model by the City of Everett? a I Yes I J No <br /> Was property owner shown how to inspect and maintain their BWV? (65J Yes No <br /> Does this BWV require repair or replacement? 11 Yes [ 'No <br /> Comments: <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September23;2'0T4-' <br />