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BACKWATER VALVE INSPECTION <br /> CHECKLIST <br /> Property Address: R; ckex �f <br /> BWV inspected by: 1-,--• U3(c.t Date BWV was Inspected: <br /> 41 <br /> Inspection Checklist Loc&4.+1 K '' <br /> `Ore all downspouts and site drainage disconnected from upstream of the BWV? Yes Ng No <br /> Comments: 1"-5. '[c (I 4v`;; <br /> .�, � -cr ,tip>._-.-�� ea�cry�' ;� �,�, 5 <br /> Does BWV positioning meets minimum slope requirement of>1%? Yes No NA <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? Yes No )J1\ <br /> Can BWV be secured into the proper position? — Yes , No N A <br /> Where is the valve installed (general description, attach map)? <br /> Is the installed BWV considered an 'approved' model by the City of Everett? I I Yes E No W1/4 <br /> Was property owner shown how to inspect and maintain their BWV? Yes { I No (J A <br /> Does this BWV require repair or replacement? [ Yes I I No <br /> Comments: <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday,September 23, 2014 <br />