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R <br /> BACKWATER VALVE INSPECTION <br /> CHECKLIST <br /> Property Address: 114 10 W 24 <br /> BWV inspected by: L • �wr bp.,vu,y-- Date BWV was Inspected: : <br /> I wJ iv, to a f o b Ca-m ' a s <br /> � <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? ►/ Yes ❑ No <br /> Comments: 1 d S12(Da-) di5a)7/7//fps/ <br /> Does BWV positioning meets minimum slope requirement of>1%?- Yes n No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? Yes E No <br /> Can BWV be secured into the proper position? '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? a Yes ❑ No <br /> Was property owner shown how to inspect and maintain their BWV?1K 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 />