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x `r ACK A. VALVE INSPECTION <br /> CHECKLIST <br /> Property Address: 2_1-I 30 6eLkeir <br /> BWV inspected by: L. ,,.►tea ,,,.e.K' Date BWV was Inspected: : 2-11 0 E v61^^ <br /> oc B — cht, -Ez �,w — ��LaW V.. v( 13rdn Cl� 1L vs2.1 <br /> Inspection Checklist <br /> Are all downspouts and site drainage disconnected from upstream of the BWV? \Yes ❑ No <br /> Comments: ( -?) J4pO-4-b j/5e4sin neS / <br /> Does BWV positioning meets minimum slope requirement of>1%? ❑ Yes ❑ No <br /> Comments: 1. <br /> Can BWV be accessed for inspection and maintenance? (1 Yes ❑ No NIA <br /> Can BWV be secured into the proper position? ❑ Yes ❑ No NA <br /> Where is the valve installed (general description, attach map)? NA <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 <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 />