HomeMy WebLinkAbout663 Whidby Ave - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST
Date ~"'2 '5 ..- 0 c.f
Time 7 DO .flt.VL Received by DeV\.vtc S E (phone, person)
Location of Work to be inspected G 53 (,J CuJh~/ A v ~ .
D l
Name of person requesting inspection :e ~ v1 r '5 E- .
Address of person requesting inspection Co)4 Ya...,rJ 11">1-- ZS Phone No if (7 .-- Lf ft( <1
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other 0.::...--+e v-
INSPECTION NOTES
Inspected Date c; ~ 2- ~ -0 c.j Time 10 A bV\ By f)evt vt ( 'S
Remarks 3/~ /'/ P E S-e.-VVl'c..~ r<-o~( v-". L~lc LV~S OVL
SI,Je of' +~ ~+e( 5~+ter I
~.
--t--~ I "'-Co(""l I>"\.~
RESTORATION REQUIRED
YES
NO X
~3~ ~
Wk'd by
8]
'V E Wk'dlo!
, \.J
.-- 51' ...., s:
..... -0
~"A-G ~
~
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
[] Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # 1'1 z 78---DsCa
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Department
Water DIstribution Repair Report
'Work Order No 1t./21f? r 0 3~
ICrew ?I~ cy- L/etJ
J
DATE REPORTED (; ~ (g ~ 0 cf
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT ()(
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR t; - 23--ot.!-
TIME (e>: 00
~,M. OP.M,
REP AIR LOCATION ADDRESS " g '3
TYPE OF MAIN A . L SIZE Sf (
DEPTH OF MAIN tJ(A CLOSEST VALVE DEPTH.
;\) / A_
I
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITTING 0
METER SETTER)tf METER 0
LINE VALVE. FLANGE NUTSIBOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLAMPO DRESSERO OTHER rJ E '-'-vh/~ ~ M1-r Sk.u+o ff
SITE CONDITION GRA VEL 0 ASPHAL T 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHAL T CUT _FT CURB CUT _IT SIDEWALK_IT
DRIVEWAY CUT _IT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE .3C; P.P.M.
WATER OFF FROM g >0 A M. TO Cj _ 60A M.
FROM M. TO M.
APPL\RENT CAUSE OF LEAK. e {ec+t"'o{ I {SI S .