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:l p�,`h � t1p ^ <br /> �.� '�.o' �� r�'V � ��m41\ �S't�,.E.,�� �I�\�c��'�L�-'. '�� ��'lN <br /> � C.o���rl�l'..b� II <br /> � �(yy�C�' I S ��]f GTT.L I I <br /> PropeffyAddress:_ �q �� LJc�)maYL��^�... M��..�ea� �s •n-�x.�l in RdI.J , <br /> [3WV inspected by: L . ���. �cc��Q�Y Date 61NV was lospected: : �D f 30 _ /�or� <br /> 3 W�/ - mw.� ���vc ac�K Si �� p�,�o PW✓/�r��,�fi,r��,,,�p <br /> Inspection Checklist <br /> Are all do�vnspoufs and site drainage disconnecled from upsiream o(the BWV? �Yes ❑No <br /> Comments: l.v A�5!UN�i+'��,J as,,,sjo��,'fS <br /> Duec �'�N posifioning meets minimum slope requirement of>i%? ❑Yes ❑ No <br /> Comments <br /> Can BWV be 2ccessed for inspection and mainlenance? ❑Yes ❑ No <br /> Can dV�N be secured irlo Ihe proper posilion? ❑Yes ❑ �o <br /> Where is Ihe valve inslailed (general description, atlach map)? <br /> Is lhe inslalled BWV considered an'approved'model by Ihe Cily of Everelt'? [j Ycs �No <br /> Was property ovmer shown how to inspecl and maiNain ihcir E3W1+? ❑Yes ❑ No <br /> Does this BWV require repair or replacement? [)Yes ❑ No <br /> Commenls:i rCGOmf,� ��R{���ul�C VA�NL �� f-lao. �1Ii�- - ����'rqP�?nv �nii� $��w-y �5 <br /> Z� ' ROIwH '�� �Iq��I� I�Uf' `� Mn I�J�.� CK ya�.�i �`-/OI✓ <br /> Inspeclor's Signalure:-------- ------ -- --- Dale:_ --__— <br /> Revision: J Tuesday, September 23, 201d <br />