HomeMy WebLinkAbout1624 W 8th St - Engineering
CITY OF PORT ANGELES ~~rUJOll.248"
DEPARTMENT OF PUBLIC WORKS ~ [; :::3
. . . . . . . . . . . INSPECTION REPORT. . . . . . . (. . . .
REQUEST
'2/ _ q'-- 0 -1-
I
Date
Time
Received by
(phone, person)
location of Work to be inspected /& ~ If w 'Z +~
Name of person requesting inspection I W I "\ <.:6)C
Address of person requesting inspection 11 ~ 4r 8 Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other t .L)C",--l-eV
INSPECTION NOTES
Inspected
Remarks
Date
Time
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A.I'N-<" if u f t 6 U +-
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By
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RESTORATION REQUIRED
YES
NOV
Nt
[
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b4
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'6 'J-i~ (l-L \1 ~ I
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
o Asphalt 0 PCC 0 Other
Wo~er # ~o ~~
~COMPlETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of IJort Angeles
Public Works Departnlent
"rater Distribution Repair Report
L)w-c.oo 7-- ~o8(,
IWork Order No: :)...6 xg ,
ICrew- 71 y
1
DATE REPORTED
v- 'g-02-
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT t/'
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR.
l/- C{ - D ~ TIME. '6
16 :;;- 0/
~.M. OP.M.
W 15 1-~
REPAIR LOCA TI0N
TYPE OF MAIN
ADDRESS
B tl-c
SIZE.
DEPTH OF MAIN
CLOSEST VALVE DEPTH.
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL. 0 LONG BREAK 0
HOLE 0 CLANW 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE ~URB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE. FLANGE NUTSIBOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLANWO DRESSERD OTHER
SITE CONDITION GRA VEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOn.. AREA 0 SOn.. TYPE
CUTS ASPHALT CUT _IT CURB CUT _IT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING/V t 1lJBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE--t J 1 P.P.M.
WATER OFF FROM
'9 /-fM. TO
9 PM.
/ J4p~v+m-ef1f- /3/ DfJ
/ ny,
{JU+-
FROM M. TO
M.
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APP ARENT CAUSE OF LEAK.