HomeMy WebLinkAbout1415 S Oak St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT . . . . . .
REQUEST
Date 4-- ro - oc.f
Time 700 AM
Received by V, ill" fsE (phone, person)
Location of Work to be inspected Ic.fl S- :;...'l ()o... fc.
Name of person requesting inspection l)LVlC/\ ('S E-
Address of person requesting inspection Cor--p Yo.....rJ Phone No 4-11-~~~q
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other tUc,---t e r
INSPECTION NOTES
Inspected Date Lf - Co -0 tf
Remarks R..e.p I a...c:. e. P f2-
Time I L
~ n./t L.e I ; V\..L
PM.. By l'JeVl1115 E '
~~i'V\.. V1.I\..4lV\ 1-0 tlV\..e-f-e. r .
RESTORATION REQUIRED
YES
NO :x..
w (L(~ 61-
f~
T
~I
6"' l
ic+'k/8lv'D A({,-i.
L Gf'?>..\J~ I )
....1/ 3:l
It::: lo'f [dlS sc>.Joc..t<.
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
o Asphalt 0 PCC 0 Other T6f'5()~ ( 0. re~
Work Order # ItfZ7~.-O{O
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Departnlent
Water Distribution Repair Report
IWork Order No (t,Z"'7 S' ---DC D
ICrew 7(7 ~ c.v€.J
DATE REPORTED t(. - 5 -o'f
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT J(
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR. if -{p --ot.(
TIME I 2.-# 00
DA.M.~.M.
TYPE OF MAIN
ADDRESS t 41'
A-C
So o~k
o if
SIZE 0
....
REP AIR LOCATION
DEPTH OF MAIN
3'
CLOSEST VALVE DEPTH.
{~ r
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)I CURB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLAMPD DRESSERD OTHER fJ..E tJ{ IJ~ f rtte:tcr 5kut--b{:E
I I '
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA)i SOIL TYPE
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING 0 A TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE .P.P.M.
WATEROFF FROM 8 A M. TO g. j'''^M.
FROM
M.TO
M.
APPARENT CAUSE OF LEAK.
{)(~
~ ' 'J1{>l-- brrttle
I ,