HomeMy WebLinkAbout2608 Franklin Ln - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date {) - ) q -O'J
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)
266 <2?Ff\(_N1kt 7u 1-C{/U<
'f7"t-U I l ((j '7
/ 1 f1t +- B Phone No
Permit No
Chimney Plumbing Final Sewer Excav Other I J-J 2\....H ~
Sewer Foundation Framing
INSPECTION NOTES
Inspected Date
Remarks
Time
R e;?~/ ~
~b{)0 U) ,tA-
By
I'} '.. - J.. . f ~
~ C - J-.. t-:< //{:::i--;7e
~;.I J ( {' '};cl--€> 15 ~-1 '
, , f
RESTORATION REQUIRED YES
i-'f--:O-" t -ecA-S-t-
l~
~
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
NO ~~
~.( c-
3D2-~ <
1
t
~
o Asphalt 0 PCC L' 0 Other
WorkO~ IJc;t?
~PLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
LIty 01 lJort Angeles m..
tf-h;- .,..
Public '" orks Departnlent ~"3 'ft9
\Vater Distribution Repair H.eport
Icrew
IWork Order No. [I ) L(~
I
/?
DATEREPORTED LJ--/C{r-D I
7/1
CONDITION ENlERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT 0
LEAKAGE SURVEY/{' OTHER 0
DATE OF REPAIR. C;--11.-o} TINIE. 11;0
Ah6 <g
~ (( c -:"f--. SIZE
REP AIR LOCATION ADDRESS
kf"A.M. DP.M.
F vcfl1t I< t)u t CA /V -e
TYPE OF MAIN
DEPTH OF MAIN
~(
CLOSEST VALVE DEPTH.
COMPONENT REPAIRED. /"
MAIN JOINT 0 CIR. BREAK g...-' SPLIT BELL 0 LONG BREAK 0
HOLE 0 CL~ 0 OTHER
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
OTHER.
COMPONENTS OF REPAIR. CL~RESSERD OTHER
SITE CONDITION GRA VEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHALT CUT _IT CURB CUT _IT SIDEW ALK _IT
DRIVEWAY CUT _IT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE i 3/ P.P.M.
WATEROFF FROM ) A,'}ot:TO I' J6~.
d U+ / 1~/"
c:;-ho (/) -e ~
FROM M. TO
MfII-
5-e -e
~ !3)--CCLI(
APPARENT CAUSE OF LEAK.