HomeMy WebLinkAbout104 Viewcrest Ave - Engineering
D IV - 200":/ - 110 'f
CITY OF PGRT ANGELES
DEPARTMENT QF PUBLIC WORKS
. INSPECTION REPORT. . . . . .
REQUEST
Date / V - y- - c c
..... /
Time
1/-.('(/ //17
Received by
rEf? ~ r /tv ~ (phone, person)
,.:----.-
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
(tI ~ VIEtV CI\E.J' T
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17-r<-4.d
Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
Jt.ct # 2." c) t
INSPECTION NOTES
Inspected Date / P ~ 'f
Remarks 5' Ere /; / C E
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L.eA-1<
Time ;J -' :; t> r /'1 By If' t:- /1/
P' A/p ere J-/ Pcw,,1 L- /<..
RESTORATION REQUIRED
YES ~ NO
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o ./112 le.r.
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SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel
D Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt D PCC D Other C V IV C f{ E T e-
Work Order # I 7 tt 't- ,P
~ COMPLETE;2.- I~ -{)J /1'14-
~NCOMPLETE
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(Continue on reverse side if necessary)
City of Port Angeles
Public Works Department
Water Distribution Repair Report
~ w - 200:t- '1-0"1
IWork Order No'
17#Y-
Reported: I () / ~/ C 0
Repaired. I ~ / ~/ ~ C/
Condition.
Source'
Emergency V Routine
Citizen Complaint ~
Leakage Survey _ Other
ICrew: 1\ (J N
(
P c-IV/V/S J,KI(,~,.;t~'p
,
Repair Location.
Address
/0'(- V/EwCXeST
s- I .A/?/f. T H 1,= PI/?7,ErX
Lac Description.
Component Repaired.
Main Line IDU:
Main
Joint Cir Break
Long. Break _ Hole
Split Bell _
Clamp _
Other
Service:
Line Valve:
Hydrant:
Other:
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 {/ r //11 /' EIC c (j f firE 1/11'_
Gravel Roadway _ Asphalt Street _ Sidewalk "./
Top Soil Area t.-/ Soil Type _
Curb Cut: Ft.
Sidewalk Cut: Ft.
Main Condition.
Diameter' Inches
Material.
Depth of Cover' Ft.
Internal Lining:
,.
Joint Type:
External Prot:
,. .
Tuberculation: N/ A
External Corrosion. N/A
Special Conditions: Bedding:
Minor
Localized
6- /f.rt VE L
Severe
Extensive
Other Structures.
Samples Taken: Pipe Section _
Coupon _
Water Off: From I (J / 'f / C U To I;' ')&, LM
From 1/// 'f / PI' To ~ J:..M
Apparent Cause of Leak: ~ i f' E
(~ENP
t8/'t R/<e
IA/ I 7
TI(I
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5/19/98
Page 1
PW-902.09