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"Irfp'PtfJhS' <br /> 11PoPo. BACKW AaTER VALVE NSPECTliON <br /> CHECKUST <br /> Property Address: 1-1 OG adn al 5$ <br /> BWV inspected by: L. J LP,/bcr,Gu/r Date BWV was Inspected: : <br /> Inspection Checklist L€fF InAtsictq e — (A.a resrAi r.e <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: <br /> Can BWV be accessed for inspection and maintenance? (l Yes ❑ No <br /> Can BWV be secured into the proper position? ❑ Yes n No <br /> Where is the valve installed (general description, attach map)? <br /> Is the installed BWV considered an `approved' model by the City of Everett? ❑ Yes n No <br /> Was property owner shown how to inspect and maintain their BWV? [l Yes ❑ No <br /> Does this BWV require repair or replacement? ❑ Yes ❑ No <br /> Comments: <br /> Inspector's Signature: Date: <br /> Revision: 2 Tuesday, September 23,201'4 <br />