HomeMy WebLinkAbout1835-39 W 13th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT. . . . . .
.....
REQUEST
Date I 2 - 27 - CJ C>
Time 1 A,w\.
Location of Work to be inspected /8 E; S. I $ ~ ,.}
Name of person requesting inspection D~tt 't '5 E
Address of person requesting inspection I 7i!~ 'I
Type of Inspection (circle appropriate one)
Sewer Foundation Framing
Chimney Plumbing
INSPECTION NOTES
Inspected Date I Z w Z c) C ,.,
Remarks Kef/~c e I Ii Cd r f>
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Time
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Received by Dl.lA \1\ S l:'" (phone, person)
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Permit No
Final Sewer Excav Other W 4. -f e. .,.
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RESTORATION REQUIRED
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YES
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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
Work Order # I 705
P!J. COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
~ (A) - z.ov 1- FI- {"j-
City of Port Angeles
Public Works Department
Water Distribution Repair Report
tWork Order No 17~~
Reported: 1'2- /28'/ X
Repaired: I Z- /2'-7/ CV
I Crew: 71-", - 7ZC; ~ 7z.3
Condition. Emergency Routine
Source Citizen Complaint X
Leakage Survey _ Other
Repair Location.
Address
Loc Description.
Component Repaired.
/83:) 1 I 213 "-)
"
.--:-/ --+ --7
CLf) ( Co <--.
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I 3 -f.!:- s::t
tJ4.ie.1 .5LrVI L(L
OK (
Main Line ID#:
Main. Joint Cir Break:
Long Break: _ Hole
Service:
Line Valve:
Hydrant:
Other:
Tap_
Flange Nuts, Bolts
Branch
C~,!J /Je ,~
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Repair Type: Clamp _
Site Condition: Surface
Curb
Damage:
Cuts: Street Cut: Ft.
Split Bell _
Clamp _
Other
Corp. Stop ~
Valve
--rviJtJ'"-Cj -
Pipe _
Stem
Barrel
Curb Stop _
Bonnet
Dresser
Other Re.O {c...CE "",-e:.v\..t
I
Gravel Roadway X- Asphalt Street _ Sidewalk
Top Soil Area _ Soil Type _
Main Condition.
Diameter'
Material.
Depth of Cover'
Internal Lining:
Tuberculation.
External Corrosion.
Special Conditions.
Curb Cut: Ft.
Sidewalk Cut: Ft.
JI"
Inches T
L/ut -r; l e
Ft. '-I'
Lo I-'lC-
"
Joint Type
External Prot.
N/A
N/A
Bedding:
Other Structures.
Minor
Localized
Severe
Extensive
Samples Taken. Pipe Section _
Coupon _
Water Off' From ill Z q I t:V To 10. 30 ~ M
From J~J!::!:L.! CTO To II' OD L1 M
Apparent Cause of Leak: ~tJlJ(?f Tubr;L*'\ (rvt pr ofJer( "-J .f' k ,ed
'/ _) { I f
5/19198
Page 1
PW-902.09