HomeMy WebLinkAbout1107 Glenwood St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST )J - t?
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Date I - Time
Received by
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
II D 7 c;./..e 4/ A/ tA.J 06 cI
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/ {fit 6-12 Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other LAJ C{ ~
INSPECTION NOTES
Inspected
Remarks
Date Time
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1:2,-/ ~ 'W~ II'
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RESTORATION REQUIRED
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SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
YES
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NO
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D Asphalt D PCC D Other
Work Order # b?- 7 Y
~ETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty 01 IJort Angeles
..J./~ CA..) F ~ ~ '2 "7 <{
Public 'Vorks Departnlent
'" ater Distribution Repair Report
IWork Order No .6.)... 7 'f ICrew 7 / r
DATE REPORTED 7- 7,.-D7 /
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COIvtPLAINT ~
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR. 1-J-c 1 TIIvlE. )0 ArM"OA.M. OP.M.
REPAIR LOCATION ADDRESS II 01- c::, ( ~tJ...) ~ 00 d
TYPE OF MAIN ~ < (fltl C. SIZE
DEPTII OF MAIN
CLOSEST VALVE DEPTII.
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL. 0 LOA)9 BREAK OJ r IJ.- 4/1~
HOLE 0 CLAMP 0 OTHER d~4.) '€Il_ C> CL ,ActJ.-t/l.
SERVICE TAP 0 CORP STOP 0 PIPE 0 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
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A r ~II C 6):?JL '6- 6-/u~
, L o..r
OTHER.
COMPONENTS OF REP AIR. CLAMPO DRESSERO OTHER
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOn. TYPE
CUTS ASPHALT CUT _IT CURB CUT _IT SIDEWALK_IT
DRIVEWAY CUT _IT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE
WATER OFF FROM Jt> k
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P.P.M.
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