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SACKWAT R VAj 'E CT ACT ON <br /> C ECKUST <br /> Property Address: I5 I S— Lsyri bp,Arot, Ave_. <br /> BWV inspected by: L. -i w,c(pa u err Date BWV was Inspected: : 10 31 2 3o Pr% <br /> 7.3 t12 <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? 14 Yes No <br /> Comments: •-I/5c61)4n <br /> Does BWV positioning meets minimum slope requirement of>1%? Yes n No <br /> Comments: <br /> Can BWV be accessed for inspection and maintenance? c Yes 7 No <br /> Can BWV be secured into the proper position? ►i Yes I I No <br /> Where is the valve installed (general description, attach map)? /4 s;4te c Eti ,c 30s1- <br /> l«sY-drAIA, — <br /> Is the installed BWV considered an `approved' model by the City of Everett? [0 Yes n No <br /> Was property owner shown how to inspect and maintain their BWV? pc] Yes No <br /> Does this BWV require repair or replacement? (1 Yes No <br /> Comments: <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23, 2'014' " <br />