HomeMy WebLinkAbout721 E 2nd St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST: . ~
Date / -' )6- (5 ( Time
Received by
(phone, person)
Location of Work to be inspected 7.A. I E: < f JI! ) :) +
Name of person requesting inspection T- {>> , ( & y
Address of person requesting inspection ~ -r kit f-(J Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other L,..J~ ~
INSPECTION NOTES:
Inspected: Date
Remarks:
Time
I<~ ~' y
5-erlJi' (-e V ).;-e
~'w
By
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RESTORATION REQUIRED . . . . .. YES
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SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC t < 0 Other
~o~der #" 6/ Y
~COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty 01 IJort Angeles
Public 'Vorks Departnlent
VVater Distribution Repair Report
IWork Order No: b " IJ:(
lerew: 7 I r
DATE REPORTED:
CONDITION: EMERGENCY 0 ROUTINE 0 CITIZEN COIv1PLAINT 0
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR: 7:- / {,- C> I TIME: 7 ftA.. OA.M. OP.M.
E :Lnd
TYPE OF MAIN:
7AI
2.,( fl//c SIZE:
.
5-1 /
REPAIR LOCATION: ADDRESS:
DEPTH OF MAIN:
CLOSEST VALVE DEPTH:
COIv1PONENT 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 ~CURB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE: FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT: BRANCH 0 VAL VE 0 BARREL 0
OTI-IER:
COMPONENTS OF REPAIR: CLAMPO DRESSERO OTHER
SITE CONDITION: GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOn.. AREA 0 SOn.. 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 dLP.P.M. ;h tJ J..r.> 0 U 1- oF-
WATER OFF: FROM 7" JD It1. TO r,JOJt!1- () ~-eYL/l 'C.--R..-
FROM
M.TO
M.
APPARENT CAUSE OF LEAK:
f3IrL . 11/ -e
/(v r' L-~J /P-e-