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BACKWATER VALVE INSPECTION <br /> CHECKLIST <br /> Property Address: 1 t l L20k� <br /> BWV inspected by: Date BWV was Inspected: : 17- t °- <br /> 6 <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? ❑Yes ❑ No <br /> Comments: <br /> Does BWV positioning meets minimum slope requirement of>1%? ❑Yes ❑ No <br /> Comments: NA <br /> Can BWV be accessed for inspection and maintenance? ❑Yes ❑ No tJA <br /> t <br /> Can BWV be secured into the proper position? ❑ Yes ❑ No f ¢l <br /> Where is the valve installed (general description, attach map)? ;�Jf <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 '4\ <br /> t <br /> Does this BWV require repair or replacement? ❑Yes ❑ No tjA t <br /> Comments: t1('t 3 14 t)z{ <br /> Inspector's Signature: "; Date: `/2-/63— <br /> Revision: 2 Monday, February 02, 2015 <br />