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410‘6,/%"--.4 BACKWATER VALVE INSPECT <br /> ION <br /> CHECKLIST <br /> Property Address: 25-0 to0 vv‘o,�.r - 5 <br /> BWV inspected by: L. Jvv�q b�%P Date BWV was Inspected: : I 1 `gm. <br /> — /4' e{ .., ,,,. <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? ❑ Yes 11 No <br /> Comments: All elriat (ore 5. -l.r,,'.,,- <br /> Does BWV positioning meets minimum slope requirement of>1%? Et Yes ❑ No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? X Yes ❑ No <br /> Can BWV be secured into the proper position? It1 Yes ❑ No <br /> Where is the valve installed (general description, attach map)? \ t_v Iraq s-InD ou--651‘16 — Sl,12 <br /> Is the installed BWV considered an `approved' model by the City of Everett? NI Yes E No <br /> Was property owner shown how to inspect and maintain their BWV? Yes ❑ No <br /> Does this BWV require repair or replacement? ❑ Yes [k No <br /> Comments: 1-4rTv , 1,45 ovir-olaw, <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23, 2014 <br />