HomeMy WebLinkAbout514 E Ahlvers Rd - Engineering
CITY OF PORT ANGELES DkJ-<.)"',r-2vr
.
DEPARTMENT OF PUBLIC WORKS fJ 1 r
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . ~
REQUEST
Date q --I' -0 7-
Time
Received by
(phone, person)
Location of Work to be inspected s- ) '-I Ifil- L u '-e roC;; cfr 5 /2
Name of person requesting inspection 'Y W t \ (G '::
Address of person requesting inspection / '1-+4. +-I/' Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other ~
INSPECTION NOTES
Inspected Date
Remarks
RESTORATION REQUI ED
YES
./
NO L/
)it
!f)+~v~V)
R ~
t
7ft{ ff
. i oS- (
() Jr-I u-e _ (/..J C-'. Y --!~
s / g /1A /i/,e J?'
11 t
~~ rv
J~~
6 J~, 1-u~(S
If
SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel }.(1Asphalt D PCC D Other
D Repaired by City ~~k ..9rder # ?-. 2-/ f
[] Repaired by Permittee ~MPLETE f\'t<2U. t-efc..\ t-e:-l w 't'\-~
~ 0 No Damage Found 0 INCOMPLETE 4"t M, X C\ - '21- a A
/i f (v A5a,o.{-f ?JAf-d. 4{2f'-of..,. 3'><, 20' . \ \e:.
I ~ -----ill! 0 I v I
(Cont ue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
ClfY of Port Angeles
Public 'Vorks Departnlent
Water Distribution Repair Report
D \.V- 2. ~-/ 'j-. 2. '2 ( ~
'Work Order No:
~A( q
ICrew>
7 It(,
DATE REPORTED'
1- I ?-c.:) 7-
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT /
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR,
q - t 6 - c- 2- TIME,
sr€'-tL C-II~
ADDRESS J V
~ k1A.M. DP,M.
If 1-1 [-1/,-< V/
REPAIR LOCATION
TYPE OF MAIN
SIZE.
DEPTH OF MAIN
CLOSEST VALVE DEPTII.
COMPONENT REPAIRED,
MAIN JOINT 0 CIR. BREAK 0 SPLIT BElL 0 WNG BREAK 0 I 1f-
HOLE 0 CLAMP 0 OTHER /( -!pI to( C o-f.? l": ~ V
SERVlCE TAP 0 CORP STOP 0 PIPE ~URB STOP 0 FITTING 0
METER SETTER 0 METER 0
p ~ 5?vt/t c-z
LINE VALVE. FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTHER
COMPONENTS OF REPAIR, CLAMPO DRESSERD OTHER
SITE CONDITION GRAVEL~PHALT iii" SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHALT CUT3XZO'FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
cm.oRINE RESIDUAL SAMPLE
P.P,M.
WATER OFF FROM tf If
M,TO
:2PM.
/ /;~() S e_ 0 d+ C.i f- 5el/(/iC-Z
FROM M. TO
M.
DI j !JlrffH-e ~F r/):?*-
A-(p/~.~~e C:-(~ /f-it /U~e.u' :?/Y'" f1:-
APPARENT CAUSE OF LEAK.
IlJDW