HomeMy WebLinkAbout508 S Alder St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
OW -200 1- -~ t(;()
REQUEST
Date 7 - I~- IJb
Time
Received by
(phone, person)
Sewer Foundation Framing
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I /f f1t ~6 Phone No \'(':)
Permit No \j-~
Chimney Plumbing Final Sewer Excav Other [)....JzA.... ~ b
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
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INSPECTION NOTES
Inspected Date
Remarks
Time
By
.
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I 1A!
5+h
l'
. '1 0
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RESTORATION REQUIRED
I
. YES
I
/
NOL/
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
o Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC I 0 Other
Wor~rder # /( 71 G
~MPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
City of Port Angeles
Public Works Department
Water Distribution Repair Report
U w - 2001 - U, /fo
'Work Order No' /tlf 6
Reported. 1 / / h (fD Condition.
Repaired. 1-/ /1-1 ~ Source.
ICrew.
Emergency /" R~ine
CItizen Complaint V
Leakage Survey _ Other
7/Y
Repair Location.
Lac Description.
So ~
)4-) IJ ~ $c4-
Address
Component Repaired:
Main Line ID#:
Main.
Joint Cir Break
Long. Break _ Hole
Split Bell _
Clamp
Pipe /'
Stem
Barrel
Other
Service:
we Valve:
Hydrant:
Other:
Tap _ Corp Stop_
Flange Nuts, Bolts
Branch Valve
Curb Stop _
Bonnet
Repair Type: Clamp _
Site Condition: Surface
Curb
Damage:
Cuts: Street Cut: Ft.
Dresser
1- <.l6VJ
Other U AfI b" , (., 5
tr ;;; E- /1~
,
Gravel Roadway Asphalt Street Sidewalk
Top Soil Area.:Z Soil Type _ -
Curb Cut. Ft.
Sidewalk Cut: Ft.
Main Condition:
I .f A-/'
Diameter' Inches 6. '--"
Material.
Depth of Cover Ft.
Internal Lining:
,.
Joint Type:
External Prot:
Thberculation. N/ A
External Corrosion. N/ A
Special Conditions' Bedding'
Other Structures:
Minor
Localized
Severe
Extensive
Apparent Cause of Leak:
Samples Taken: Pipe Section _ Coupon ---.!I J)..J--R-
Water Off: From1~JI1-/0D To 2.36f'M / );6 d5~
Fwm 2.i~1 0>3 To ") :k>b1. / J; r () t! f,t;t. j ..R.
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5/19/98
Page 1
PW-902.09