HomeMy WebLinkAbout1026 W 5th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT . . . . . .
REQUEST
Date !;7-- - ;;. t - () I
Time II - 3 (1 /f ~ Received by B / L L
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
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Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
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INSPECTION NOTES
Inspected Date ! ? ~ ? <f- -(J / Time I Y- . J tj
Remarks J." /'1 A i IV /J It c A K
By ,;f # /V
RESTORATION REQUIRED
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YES V c.11/;'''NO.&,,,.K
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
Work Order #
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o COMPLETE
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(Continue on reverse side if necessary) ,
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STREET SUPERINTENDENT (DATE)
CIty of Port Angeles
Public Works Department
Water Distribution Repair Report
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IWork Order No: ) .of/V
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DATE REPORTED' /,r - .?- r--t> I
CONDITION EMERGENCY ~ROUTINE 0 CITIZEN COMPLAINT 0
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR..
I r -.?-Y--V J TIME.
ADDRESS I 0 ? ,
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[j;t;(.M. OP.M.
REP AIR LOCATION
TYPE OF MAIN C /! >' ,. / /( r; ^I SIZE. ) / ,
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DEPTH OF MAIN L CLOSEST VALVE DEPTH.
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COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL. 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER ;) jJ~ Ej'j'c~.J 1- / Cr i' f? I/C , I/'L
SERVICE TAP 0 CORP STOP 0 PIPE 0 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
OTHER.
COMPONENTS OF REPAIR. CLAMPO DRESSERl3' OTHER :?- ;J1i E SfC/l j -I N i,r", C rl/c
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE VI; / .,. H f L /9 11/ T J'
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
. EP
MAIN CONDITION INTERNAL LINING /? € It l <.. () i\ t P "TImERCULA TION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE ,) P.P.M.
WATER OFF FROM/ ).:JP p M.TO ;) ve- I'M.
FROM M.TO M.
APPARENT CAUSE OF LEAK. OLP L 1;11/ t t (il\tt-;Y P
111/1 w1A/6 .