HomeMy WebLinkAbout2101 W 18th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT. . .
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REQUEST
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Date A
Time
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
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Received by
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Permit No
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Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected Date
Remarks
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RESTORATION REQUIRED
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
CI No Damage Found
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... YES
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o Asphalt 0 PCC
VYo~der #
~ COMPLETE
o INCOMPLETE
o Other
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STREET SUPERINTENDENT
(DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT. . . . .
i) W 2001 ~ 11-0 L.
REQUEST
Date I 0 - }- t7 (/
Time 7 ~ v 0 A /'1
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Received by 7 Eli Ie I W,(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
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Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected Date / u - '} - v C/
Remarks JJ /1. E A i< I t of" :3
Time I tJ
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RESTORATION REQUIRED
YES
NO V-
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
D Repaired by City
[] Repaired by Permittee
D No Damage Found
Work Order #
~OMPLETE
o INCOMPLETE
o Other
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STREET SUPERINTENDENT
(DATE)
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City of Port Angeles
Public Works Department
Water Distribution Repair Report
tWork Order No:
17v';}-
Reported I () I '3 I (/ C
Repaired. / fl I J I () "
Condition.
Source
Repair Location.
Address
Loc. Description.
Component Repaired.
Main.
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Emergency c...-- yutine
Citizen Complaint
Leakage Survey _ Other
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Main Line ID#:
Joint Cir Break
Long. Break _ Hole
Other
Service:
Line Valve:
Hydrant:
Other:
Split Bell _
Clamp _
Tap _ Corp Stop_
Flange Nuts, Bolts
Branch Valve
Pipe v
Stem
Barrel
Curb Stop _
Bonnet
Repair Type: Clamp _
Site Condition: Surface
Curb
Damage:
Cuts: Street Cut: Ft.
Dresser
Other f' If' E 1- ;1/ofw ME TEj( S T t/
Gravel Roadway _ Asphalt Street _ Sidewalk
Top Soil Area --- Soil Type _
Main Condition.
Curb Cut: Ft.
Sidewalk Cut: Ft.
Diameter- Inches
Material.
Depth of Cover- Ft.
Internal Lining:
1"
,. ,
Joint Type.
External Prot:
Tuberculation: NI A
External Corrosion: N/A
Special Conditions: Bedding:
Minor
Localized
GIfAl/eL
Severe
Extensive
Other Structures.
Samples Taken: Pipe Section _
Coupon _
Water Off: From I P 1 J 1 V'"V To 9 'NI AM
From/V I J It?c- To IP',?P LiM
Apparent Cause of Leak:
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5119/98
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PW-902.09