HomeMy WebLinkAbout127 W 4th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . INSPECTION REPORT. . . . . .
.....
REQUEST:
7-;;-P :3
Date
Time
fj' : if 5 ,j.-47Received by jJ I Y LE
(phone, person)
location of Work to be inspected / ?- ? w t ~
Name of person requesting inspection P /I / L e
Address of person requesting inspection I ? ~ 9" ~ Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date 1 - ;2-.... CI"3 Time / tJ : V' / A 4 By
- I --/} <"') " I?' ...a -
Remarks: /- X e "./I1A /,1(/ D /!E'TK., j /J r
5' ee{)Ef;?, 3 I xf? / /1/( E/1
((tiff
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RESTORATION REQUIRED . . . . .. YES
NO
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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 0 Other L 4 U--,H'
Work Order # W /~ b tP ?~
~OMPlETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT (DATE)
City of Port Angeles
Public 'V orks Departnlent
", ater Distribution Repair Report
IWork Order No: tv f 0 t1 '1 t/
'Crew: RPAI' J .1"9/V/VET Te 7...1f-I
. I
DATE REPORTED:
CONDITION: EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT 0
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR: 7-?- -~
TIME:
DA.M. DP.M.
TYPE OF MAIN: C,"f l' T
I'
DEPlli OF MAIN: ;J~.>
/;-7 w ~~ S//Cc?E7
//
r /? J?1'f~ SIZE: ?
~
CLOSEST VALVE DEPTH: ;;.. S-
REPAIR LOCATION: ADDRESS:
COMPONENT REPAIRED:
MAIN: JOINT D CIR. BREAK D SPLIT BELL. D LONG BREAK D
HOLE ~ CLAMP D OTHER
SERVICE: TAP D CORP. STOP D PIPE D CURB STOP D FITTING D
METER SETTER D METER D
LINE VALVE: FLANGE NUTS/BOL TS 0 STEM D BONNET D
HYDRANT: BRANCH D VALVED BARREL D
OTIIER:
COMPONENTS OF REPAIR: CLAMP~RESSERD OTHER
SITE CONDITION: GRA VEL D ASPH.t\l6T D SIDEWALK D CURB D
TOP SOIL AREA [gI"" SOIL TYPE
CUTS: ASPHALT CUT _FT. CURB CUT _FT. SIDEWALK _FT.
DRIVEWAY CUT _FT.
MAIN CONDITION: INTERNAL LINING TUBE}l.CULATION-MINOR D SEVERE D
EXTERNAL CORROSION LOCALIZED lQI' EXTENSIVE D M
CHLORINE RESIDUAL SAMPLE P.P.M. III f} ,Alp ( S' tI {/ (' i? CI VV,,,v . .;9/-+
WATER OFF: FROM
M.TO
M.
FROM
M. TO
M.
APPARENT CAUSE OF LEAK: L. ( AlE
IS
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