HomeMy WebLinkAbout1321 W 5th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . .
/
REQUEST
Date
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)
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Phone No
Permit No P3
Sewer Excav Other ~c...-/
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Sewer Foundation Framing
Chimney Plumbing Final
INSPECTION NOTES
Inspected Date I'o./l? / ~D 00 Time
Remarks (?b h7 'p/~-E-
By
~
/
RESTORATION REQUIRED
YES
NO
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CITY OF PORT ANGELES J)1AJ~2-"o1- 2-18t.f
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . .. ).1 b
REQUEST
Date -r- 't> - 02-
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)
/]~I u S+~
-rWi/(a/<-
/11t +-.8 I Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other we^-.. ~;-
INSPECTION NOTES
Inspected Date Time i By
Remarks /'? -e,v-e W -e c! b~ c k... S r d -e <5 J-
[A) C~ +-e V ~+ -e Y Pi I ~-k) ~ eLL Jc
JiJb Ll)(A..~ cloJ ~- )~41/-
RESTORATION REQUIRED
YES
/'
NO~
\ I f) I jJ1' , '3 1-. \ L0 C;~1
11G ~u ;/
f.)'
<~ ~.. A--- c.... rJ
S~
W ~ 2-3~(
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
~PLETE
o INCOMPLETE
o Other
J/8Y
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public ,V orks Departnlent
Water Distribution Repair Report
C) ~ - "Lc?O 1- - <: (84-
'Work Order No:
DATE REPORTED
. 2.. \ ~ L{
/~ ?-.. q -61-
, Crew
71 (( ,
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT ~
LEAKAGE SURVEY 0 OTHER 0
'1- 0.--10 ~
DATE OF REPAIR. 7 - '3,)- 0 TIME. { ('~.M. OP.M.
/3:;(( ws-f~
-
REPAIR LOCATION ADDRESS
TYPE OF MAIN
SIZE.
DEPTII 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/BOLTS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
,0 ..{ AJ.fl u...J f ; 'pel N q - (1 )j
OTHER. 1" F
Bd. C k 5-( cJ -e () P- crn~fT.v-
COMPONENTS OF REPAIR. CLAMPO DRESSERO OTHER
SITE CONDITION GRA VEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING TUBERCULA nON-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE P.P.M.
WATEROFF FROM 7 A- M. TO C(A M.
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6u+-
FROM
M.TO
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APPARENT CAUSE OF LEAK.