HomeMy WebLinkAbout506 W 3rd St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST: "
Date 'f - Jq-o 1
Time
Received by
(phone, person)
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Location of Work to be inspected j yZj +- f ;' JV ~ 0 y St~ b
Name of person requesting inspection ,'W / "I (. <sX'
Address of person requesting inspection 11...::fh tr f3' Phone No.
Type of Inspection (circle appropriate one): Permit No. .1
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other I ~i-er-
INSPECTION NOTES:
Inspected: Date
Remarks:
Time By
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RESTORATION REQUIRED . . . . . . \ YES 7/ NO
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SURFACE RESTORATION: _ /'
SURFACE TYPE: 0 Unimproved 0 Gravel [l..a:Sphalt 0 PCC 0 Other
Work Order # q 3 )5-
o COMPLETE
o INCOMPLETE
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LIty 01 IJort Angeles I~)P /~.c."It- 935S
Public \V orks Departnlent
vVater Distribution Repair Report
IWork Order No:
DATE REPORTED:
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cf - 11-0 }
I Crew:
7/f
.
CONDITION: EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT ~
LEAKAGE SURVEY 0 OTHER 0
TYPE OF MAIN:
J<
DEPTH OF MAlN:
q -/~-o 3 TIME:
S610
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OA.M. OP.M.
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DATE OF REP AlR:
REPAIR LOCATION: ADDRESS:
SIZE:
CLOSEST VALVE DEPTH:
COI\1PONENTREPAIRED: ... /
MAIN: JOINT 0 CIR. BREAKl.e( SPLIT BELL, 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVlCE: TAP 0 CORP. STOP 0 PIPE 0 CURB STOP 0 FIITING 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' CL~RESSERD OTHER
SITE CONDITION: GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOn.. AREA 0 SOn.. TYPE
CUTS: ASPHALT CUT _FT. CURB CUT _FT. SIDEW ALK _Fr.
DRIVEWAY CUT _Fr.
MAIN CONDITION: INTERNAL LINING TUBERCULATION-1\.1INOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SA!v1PLE I .J ( P.P.M.
WATER OFF: FROM ) ;Jo PM. TO 11/R1;11
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FROM M. TO
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APPARENT CAUSE OF LEAK: