HomeMy WebLinkAbout1628 Milwaukee Dr - Engineering
. . . .
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . INSPECTION REPORT . . . . . .
Ov..J-dS-/~--/f 80
.....
REQUEST
Date J 1- €f - 0 )
I
Time
Received by
(phone, person)
Location of Work to be inspected ) 6 A ~ 'fill /''1 kJAuk-e'-<_ f)r-I
Name of person requesting inspection' M)' {A L/ I .f- {; J
Address of person requesting inspection ~ () D Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other { )..j O-..-~
INSPECTION NOTES
Inspected Date
Remarks
5-e rt/ ( (~ cjo~
",0/" -4(.
(:')
RESTORATION REQUIRED ))1' YES
)~f
./
t'/"
NO
\;
~
~
W I ?'f-1
SURFACE RESTORATION /
SURFACE TYPE 0 Unimproved rEUravel 0 Asphalt 0 PCC
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
~MPLETE
o INCOMPLETE
o Other
I cr~O
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
,..
City of Port Angeles
Public Works Department
Water Distribution Repair Report
,(Work Order No: 1 L{ 01'1
Reported: ) ( /)"<;h {( r
Repaired: (I I ~llq r
Repair Location:
Component Repaired:
Main:
.J
Service:
Line Valve:
Hydrant:
Other:
)
, I Crew:
Emergency V' ROj!tine
Citizen Complaint ;,/
Leakage Survey _ Other
'7/C(
,
Condition:
Source:
Address:
Loc. Description:
/6 l... ~
?);!1 i I ( w ctu k__e~.
Main Line ID#:
Joint Cir Break
Long. Break _ Hole
Split Bell _
Clamp _
Pipe ~
Stem
Barrel
Other
Tap _ Corp. Stop _
Flange Nuts, Bolts
Branch Valve
Curb Stop _
Bonnet
Repair Type: Clamp _
Site Condition: Surface
Curb
~ Damage:
Dresser Other -l( c f= /1. I--:p( b -e.. f ,.2... (U) WI rice; J( d
, . l' ~c.,
-' If;t .,,., /
Gravel Roadway L/" Asphalt Street _ Sidewalk
Top Soil Area _ Soil Type _
-.
Cuts: Street Cut: Ft.
Main Condition:
Apparent Cause of Leak:
5/19/98
Curb Cut: Ft.
Sidewalk Cut: Ft.
"7'( r1.. C
Diameter- Inches ~ rr
Material:
Depth of Cover. Ft.
Internal Lining:
v
V",.c
Joint Type:
External Prot:
Tuberculation: NI A
External Corrosion: NI A
Special Conditions: ~:
Other Structures:
Minor
Localized
Severe
Extensive
Samples Taken: Pipe Section_
Coupon~ IC#-Z
Water Off: From ;1, 7v/~ To ~ 11M
FromAljOI-!.I To )0 kM
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Page 1
PW-902.09