HomeMy WebLinkAbout1529 W 7th St - Engineering
CITY OF PORT ANGELES l) ~ -"2-o()t ~2-1 38
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
2-vA
REQUEST
Date b -- t.j-;- 6 1-
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)
1S-~ q w 7+1\
l ~\\ {C'f
L1 0L ~ 1; Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other LJ-JI\....t- CY
INSPECTION NOTES
Inspected
Remarks
Date
Time d By
:- ~f-1cu-e '!It
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~
~v i'C..-e-
~ +~1-
RESTORATION REQUIRED
YES
/
/
NO V
J
tN
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
~MPlETE
o INCOMPLETE
o Other
~13~
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Department ~"'" -z-001- - 2/38
Water Distribution Repair Report
'Work Order No:
DATE REPORTED
?'-l3'1
b- J- 62-
, Crew
flV
1
CONDITION E1v1ERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT V"
LEAKAGE SURVEY 0 OTIIER 0
DATE OF REPAIR. b -tt - 62- TIME. J'J-.1b ~A.M. ~.M.
REPAIR LOCA TI0N ADDRESS t 5";;l c,7 w 'i.fit
2. to ( ...,-
TYPE OF MAIN C - Y SIZE.
~i
DEPTH OF MAIN ~
CLOSEST VALVE DEPTH.
COMPONENT REPAIRED:
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL. 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTIIER
SERVICE TAP 0 CORP STOP 0 PIPE/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
OTIffiR.
COMPONENTS OF REPAIR. CLAMPO DRESSERO OTIIER /i-eplae-ej V~ I}-
SITE CONDITION GRAVEL ~PHALT 0 SIDEWALK 0 CURB 0
TOP SOn.. AREA 0 SOn.. TYPE
CUTS ASPHALT CUT _IT CURB CUT _IT SIDEWALK_IT
DRIVEWAY CUT _IT
5.e rUt (..e
1-1 tV <--
MAIN CONDITION INTERNAL LINING TIJBERCULA nON-MINOR 0 SEVERE 0
EXTERNAL CORROS10N LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE I 1 ( P.P.M.
WATER OFF FROM 12 36/fM. TO /, J'[)~.
M.
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FROM
M.TO
APPARENT CAUSE OF LEAK.