HomeMy WebLinkAbout228 Vashon Ave - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . INSPECTION REPORT . . . . . .
Ow -)-s-o I -I' 2- 7-
REQUEST
Date (y - I 9 - tI Q
Time 7. (//:1 /II? Received by If i ( L
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cf,
Phone No
Permit No
(phone..person)
~
~
~
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Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
IVN
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
,- /1-{;C/
Time
BKEA-/c
VALVe
Cf: Je-
/7 /'1 By
f( t'1f;'
Inspected Date
Remarks ;). I, /l7 J4. IN
;5"71 WE}'( IJr
ON
5'W
C tl( file I?
Or C t!1lIS,;;- t VASliltll'l
RESTORATION REQUIRED .
YES
NO
L/'"
L_ /fl
N
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
~OMPLETE
o INCOMPLETE
o Other LAW/V
I b )- "}
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
City of Port Angeles
Public Works Department
Water Distribution Repair Report
\) w - )..s- 0 I - ( ~). r
IWork Order No: I b ;).. 7
I Crew: f( 1/;1. pe##IJ. t-:;j-l:^~v I
, ,
Reported: {;' / 17/ V ()
Repaired: C; / If/ IJ p
Condition.
Source.
Emergency ~ Routine
Citizen Complaint l.../'
Leakage Survey _ Other
Repair Location:
Address.
~ ?- i' tI /1 Jf.I I~A/
/' I:~.J'; Or .5EI?I//C€
Loc. Description.
Component R~aired:
Main Line IDI:
Main:
Joint
Long. Break _
Cir Break 1./""
Hole
Split Bell _
Clamp _
Other
Service:
Une Valve:
Hydrant:
Other:
Tap_
Flange Nuts, Bolts
Branch
Corp Stop_
Pi
pe-
Stem
Barrel
Curb Stop _
Bonnet
Valve
Repair Type: Clamp V-
Dresser
Other
Site Condition: Surface
Curb
Damage:
Gravel Roadway Asphalt Street _ Sidewalk
Top Soil Area ~ Soil Type _
Cuts: Street Cut: Ft.
Curb Cut: Ft.
Sidewalk Cut: Ft.
Main Condition:
Diameter- Inches ;;.
Material. _ C .q oS e ..I ft v;..l
Depth of Cover' Ft. 3
Internal Lining:
"
'.-,
Joint Type:
External Prot:
Tuberculation. NI A
External Corrosion. NI A
Special Conditions. Bedding:
Minor
Localized ........---
G ~ /h/eL
Severe
Extensive
Other Structures.
Samples Taken. Pipe Section _
Coupon -
Water Off: From b d? 1 VP To f; )1 AM
From b 1 1'1IPp To 9"3" ~M
Apparent Cause of Leak: r IrE
CK-1c Ie ep
5/19/98
Page 1
PW -902.09