HomeMy WebLinkAbout924 E 8th St - Engineering
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CITY OF PORT ANGELES OW~07-tS"/~
DEPARTMENT OF PUBLIC WORKS
. . . . INSPECTION REPORT. . . . . . . . . . .
/
REQUEST
Date 1- I C' - (J (')
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)
1 ?--4
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ICr5;/
<t-- f3 Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
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INSPECTION NOTES
Inspected Date
Remarks
By
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RESTORATION REQUIRED
YES
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt
o Repaired by City
[] Repaired by Permittee
o No Damage Found
OPCC
o Other
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Work Order #
~MPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
City of Port Angeles D W ~ 007'" J S I e
Public Works Department
Water Distribution Repair Report
IWork Order No: / S 1 <1
I Crew: 7/ Y'
Reported: LI / () I {> b
Repaired: LI / tJ If) (!
Condition: Emergency Routine
Source: Citizen Complaint ~
Leakage Survey _ Other
R~ Location:
Address.
Loc. Description:
c;7--t;
J
/!: J +0
Component Repaired:
Main Line ID#:
Main:
Joint Cir Break
Long. Break _ Hole
Split Bell _
Clamp _
Pipe ~
Stem
Barrel
Other
Service:
Line Valve:
Hydrant:
Other:
Tap _ Corp. Stop _
Flange Nuts, Bolts
Branch Valve
Curb Stop _
Bonnet
Repair Type: Clamp _
Dresser
Other 1?-RIIJ~t{) 11'9' /- E-//~
Site Condition: Surface
Curb
Damage:
Gravel Roadway ~ Asphalt Street Sidewalk
Top Soil Area _ Soil Type ~
Cuts: Street Cut: Ft.
Curb Cut: Ft.
Sidewalk Cut: Ft.
Main Condition:
Diameter' Inches :2 ,r r tI c
Material.
Depth of Cover- Ft.
Internal Lining:
l'
Joint Type:
External Prot:
t.-___,
Tuberculation. NI A
External Corrosion: NI A
Special Conditions: Bedding:
Other Structures:
Minor
Localized
Severe
Extensive
Apparent Cause of Leak:
of)
From 1-1 'tilt) 0
From L-' I C' I {) 0
fl/ i-' (+f+ ~
Coupon -.lI() IIi Z
To ---L...e... M
To 1...t'-M
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Samples Taken: Pipe Section _
Water Off:
5/19/98
Page 1
PW-902.09