HomeMy WebLinkAbout717 E 2nd St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST:
Date b-, '1 - <s 1-
\)V-2-co~ - 2-,4~
21 C-
Time
Received by
(phone, person)
location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
1 17 E- AVL)
Tw " \ (~~y
/1 H\. -6-f)
Phone No.
Permit No.
()J /~~ 1/
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date
Remarks:
pYi5m
Time
f~ -f }?~\r -t'" J
, ~
Cfi-t ~,l ~
By
2~ r: S-ey(/,-C f t-:/IJ~
~-d-~r-
~11 k~vJ I )11-
iD Lf ~
5 -e;y U . ,,/ c",'
tzXJ
--
7- \0\<6" ~T ~hJ
tv
"
U
~
...... ~
~ 1\
RESTORATION REQUIRED. . . . .. YES
/'
NO ~
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC 0 Other
o Repaired by City Work Order # ::z. ( <( S--
[] Repaired by Permittee ~LETE
[] No Damage Found 0 INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
City of Port Angeles
Public Works Department
'" ater Distribution Repair Report
l)w. '2.001- 2{LI~-
IWork Order No:
DATE REPORTED:
~lll C) ,
-b -I (- 0 2-
'Crew:
II~
CONDITION:
EMERGENCY 0 ROUTINE 0 CITIZEN COIvlPLAINT 0
LEAKAGE SURVEY 0 OTIIER 0
b-Il- 6 L TIME: /1' 36 ;tA.M. DP.M.
E:2..vJ
7/7
~(< rile SIZE:
DATE OF REPAIR:
REPAIR LOCATI0N: ADDRESS:
TYPE OF MAIN:
DEPTH OF MAIN:
CLOSEST VALVE DEPTII:
COMPONENT REPAIRED:
MAIN: JOINT 0 CIR. BREAK 0 SPLIT BELL. 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE: TAP 0 CORP. STOP 0 PIPE ~URB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE: FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT: BRANCH 0 VALVE 0 BARREL 0
OTIiER:
COMPONENTS OF REPAIR: CLAMPD DRESSERD OTHER
SITE CONDITION: GRAVEL 0 ASPHAj;f 0 SIDEWALK 0 CURB 0
TOP SOIL AREA V SOIL TYPE
CUTS: ASPHALT CUT _FT. CURB CUT _FT. SIDEWALK _FT.
DRIVEWAY CUT _FT.
MAIN CONDITION: INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE I J '} P.P.M.
WATER OFF: FROM / ;, '5 c> Itt. TO /2'; 0 t.
u1--
j'hoU5 e 0
/ J1r .
FROM M. TO
M.
f :E j?),f:;~
APPARENT CAUSE OF LEAK:
13> y-( H-t-.:.e