HomeMy WebLinkAbout929 W 13th St - Engineering
CITY OF PORT ANGELES DtU'~)OI-22-~~
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date 1- 1. 7 - (') I
Time
Received by
(phone, person)
Location of Work to be inspected erA q .' fA..) f I J 1-11.
Name of person requesting inspection --r:--L-0 l( c ts--;<
Address of person requesting inspection /1 fJ ( t;- L2 Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other {~~V'
INSPECTION NOTES
Inspected
Remarks
Date
Time By
j~~r~ y- ~ d C -;J:- V-JA.-HL---
tt1 -V I c (Ve/ ~ ;Jbl/~ ~I r
(:/;o;1/A , /i
~
t}.) I
v~/
RESTORA TION REC UIRED YES NO
IJt q~~)1fll
A ,-
1__; r~ )...l ( ('--r
J 'b tIt ,
i
CI\
0
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 pce
o Other
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order # 9.2 q r
~MPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public 'V orks Departnlent
'Vater Distribution Repair Report
D c..u .~ ro 1- z. 2- ft.(
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT ~
LEAKAGE SURVEY 0 OTHER 0
DATEOFREPAlR. } - J-1-<J7 TIME. 7 IfI1i. DA.M. DP.M.
REPAIR LOCATION' ADDRESS q ~ q W 1 j fI1
.t1 ((
'^ C - ;t::--- SIZE
~~q y~
1- J-{, -dl
ICrew< / I r
IWork Order No'
DATE REPORTED
TYPE OF MAIN
DEPTH OF MAIN
')(
.)
CLOSEST VALVE DEPTII.
COMPONENT REPAIRED. J /'
MAIN JOINT D CIR. BREAK /({ SPLIT BELL. D LONG BREAK D
HOLE D CLAMP 0 OTHER
SERVICE TAP 0 CORP STOP D PIPE 0 CURB STOP D FITTING 0
METER SETTER 0 METER 0
LINE VALVE. FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLAMP~SSERO OTIlER
SITE CONDITION GRA VEL ~ ASPHALT D SIDEWALK D CURB 0
TOP SOIL AREA D SOIL TYPE
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEW ALK _Ff
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING AI A- TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION' LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE t {C;- P.P.M.
WATER OFF FROM
~/r
M.TO
1ft M.
FROM M. TO
M.
>-eHk
r J2. r<cLK
.
APPARENT CAUSE OF LEAK.