HomeMy WebLinkAbout1431 W 6th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . .
21.4
. . . .
REQUEST
Date /-w - D3
Time
Received by
(phone, person)
Location of Work to be inspected 1'I3f tJ G~
Name of person requesting inspection Df.."vtyS E
Address of person requesting inspection ~rp YCl..,J Phone No
Type of Inspection (circle appropriate one) Permit No ,___
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Oth(;~"~)
INSPECTION NOTES
Inspected Date (.-{.v' 0 S
Remarks Ke I'~~il' Z ir Cc......st
b~~4
Time By
7 VOl<'\.. II\.-\.O_~V\.. W. t l-9v I ( L. lcl~
ref,,-,r
RESTORATION REQUIRED
YES ><
NO
I I t.{'3 ( I.J 6~ ~
~- -=({( ~ zot c(. 0
~I 3"/' j)e~f
-+~ ~\
t $
.)- vv ro- 'l:
.- "'- ~\U
-
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
[] Repaired by City
[] Repaired by Permittee
[] No Damage Found
o Asphalt 0 PCC
Work Order # 227c;
o COMPLETE
o INCOMPLETE
o Other -;:;,:j~ ( (
I
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of I)ort Angeles
Public Works Departnlent
'" ater Distribution Repair Report
'Work Order No. Z~ 7CJ
I Crew 7' 5" ( 7 I f.c ( 7 { g
DATE REPORTED { .-" ~ 03
CONDITION EMERGENCY D ROUTINE 0 CITIZEN COMPLAINT )(
LEAKAGE SURVEY D OTHER D
DATE OF REPAIR. /-~ ~05
REPAIR LOCATION ADDRESS 1'1 3 (
TYPE OF MAIN C I.
u)
1"2- S 6 DA.M. ~.M.
~ t-f:.
TIME
2.(1
SIZE
3' 'r 3 (
G CLOSEST VALVE DEPTII.
DEPTII OF MAIN
COMPONENT REPAIRED.
MAIN JOINT D CIR. BREAK)& SPLIT BELL. D LONG BREAK 0
HOLE D CLAMP 0 OTHER
SERVICE TAP D CORP STOP 0 PIPE D CURB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE. FLANGE NUTSIBOLTS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLAMPj( DRESSERD OTHER
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHALT CUT _IT CURB CUT _IT SIDEWALK_IT
DRIVEWAY CUT IT .
MAlN CONDITION INTERNAL LINING ;lit TUBERCULA nON-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE .' 51 P.P.M.
WATER OFF FROM
( r M.TO 2 30rM.
FROM M. TO M.
APPARENT CAUSE OF LEAK. 6" rOU vJ! 5<-Tf { e.-