HomeMy WebLinkAbout807 E 1st St - Engineering
CITY OF PORT ANGELES !)<.J'ZU01./'iY
DEPARTMENT OF PUBLIC WORKS J(j-/--I 9
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST: / (
Date '8" - b.- ?!).
Time
Received by
(phone, person)
Location of Work to be inspected '7 () / E I 5 f-
Name of person requesting inspection ~ t--U i I C <l ;X
Address of person requesting inspection ( 'h 1 %- f? Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other W c{:~ y-
INSPECTION NOTES:
Inspected:
Remarks:
Dete " ~i~e,'r~d!i 3~ ~d~~
<t" tp,t\.~e, (~C\, /~:. 'fr, , ~~-= jtfY/
+- ~ (; F ;/(j p, E- p;r~
. I Y ,
RESTORATION REQUIRED . . . . .. YES
/'
NOV
t{1 ~€f-tti\~ 9J61 ~ IS r R V
7(0 /:rf (p~e.
f;! Lt;f(
~ i << f{ c.... r II-
A . i
..
, ~-t- ~-\ t .~ 4 ~5f-"
"-
\.;
~
-{~
tz
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
~MPLETE
o INCOMPLETE
o Other
I r /1
(Continue on reverse side if necessary I
STREET SUPERINTENDENT
(DA TEl
City of Port Angeles
Public Works Department
Water Distribution Repair Report
i
/
!
IWork Order No:
DATE REPORTED:
(/ Lj l/ 1
II - l ~ -0 I
fCrew:
7/Y
CONDITION: EMERGENCY D ROUTINE D CITIZEN COMPLAINT V'
LEAKAGE SURVEY D OTHER D
DATE OF REPAIR: 11- rlf-o 1 TIME:
REPAIR LOCATION: ADDRESS: ~ 0 '(
DAM. DP.M.
f
15+
TYPE OF MAIN:
SIZE:
DEPTH OF MAIN:
CLOSEST VALVE DEPTH:
COMPONENT REPAIRED:
MAIN: JOINT D CIR. BREAK D SPLIT BELL D LONG BREAK D
HOLE D CLAMP D OTHER
SERVICE: TAP D CORP. STOP D PIPE D CURB STOP D FITTING D
METER SETTER ~ METER D
LINE VALVE: FLANGE NUTS/BOLTS D STEM D BONNET D
HYDRANT: BRANCH D VAL VE D BARREL D
OTHER:
COMPONENTS OF REPAIR: CLAMPD DRESSERD OTHER
SITE CONDITION: GRAVEL D ASPHALT D SIDEWALK D CURB D
TOP SOIL AREA D SOIL TYPE
CUTS: ASPHALT CUT _FT. CURB CUT _FT. SIDEWALK _FT.
DRIVEWAY CUT _FT.
MAIN CONDITION: INTERNAL LINING TUBERCULATION-MINOR D SEVERE D
EXTERNAL CORROSION LOCALIZED D EXTENSIVE D
CHLORINE RESIDUAL SAMPLE P.P.M.
WATER OFF: FROM :J-p M. TO ~ ?M.
FROM
M.TO
1n -e.* y '5 ~ fit: J- {/'J ~ ~ j} )j.dl<-k!.
APPARENT CAUSE OF LEAK:
I},.J (6/f'J ~r