HomeMy WebLinkAbout2811 S Peabody St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . INSPECTION REPORT. . . . . .
REQUEST
Date 1:> -20 - oLf
Time 7:DO 1Ii/"'- Received by .DevtV\. IS €. (phone, person)
Location of Work to be inspected 2 <is ( l s.-o {I~A_kc~'-1
Name of person requesting inspection DCV\I^ ,-s ~ '
Address of person requesting inspection ~rr Y"--IJ 1'1 "T ~ Phone No f' -r - l/-f49
Type of Inspection (circle appropriate one) Permit No -
Sewer Foundation Framing Chimney Plumbing Final Sewer Excavate t<JtL 9'
INSPECTION NOTES
Inspected Date 5"" -- ZD - D '-(
Remarks /fe ;t:'tt.1 r 3/'{ p- E ..
I
Time 10 - 00 ,1--~By
T(.) 101 ~~ bro k €. V\. 0...+ ceo V',1 ~o LJ .
J I f
RESTORATION REQUIRED
AI!-K A.vE.
YES
NO X
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-
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
[] Repaired by City
[] Repaired by Permittee
[] No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # 1'-(-1- 7 g - tJZ<;?
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 14 "L 78 .- 01...~
1 Crew 7' -:; "+- er- LtJ
]
DATE REPORTED S -1$ -oL(
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN CONlPLAlNT ~
LEAKAGE SURVEY 0 OTHER 0
DATE OF REP AlR. '5 - Z-o - Dlf
REP AlR LOCATION ADDRESS Z 8 ( t
Q V.L.
DEPTH OF MAlN c{ ,
$.0
10 DC> ~.M.
(J e6.. bod y
""7 {,
SIZE L--
OP.M.
TIME
TYPE OF MAIN
3~r
CLOSEST VALVE DEPTH. _ c--
CONlPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL 0 LONG BREAK 0
HOLE 0 CL~ 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE Ji CURB STOP 0 FITTING 0
:METER SETTER 0 :METER 0
LINE VALVE FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLANlPO DRESSERO OTHER 3/0.{ c...ovo.-p_ U"'-I~,^- p.L iv~'~
SITE CONDITION GRA VEL 0 ASPHAL T 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE AJe;L + I U L
C1JTS ASPHAL T CUT _FT CURB CUT _FT SIDEWALK_FT
DRlVEWAY CUT FT
MAIN CONDITION INTERNAL LINING N/A TIJBERCULATION-MlNOR 0 SEVERE 0
EXTERNAL CORROSION (LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SANlPLE "3<0 P.P.M.
WATEROFF FROM q A M. TO q - ISAM.
FROM M. TO M.
APP.i\RENT CAUSE OF LEAK /-:>I"DVl^-A. s..dtl e