HomeMy WebLinkAbout300 Brown Rd - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . . .
H-TE wF 773"
REQUEST
Date 8- t's -03
Time
Received by De&/( v{ ( S
-
(<-
- , (phone, person)
Location of Work to be inspected 200 8ro<.)lA...
Name of person requesting inspection UHVlI 5 E-
Address of person requesting inspection ~~ p Yo-.r)
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing Final
Phone No
Permit No
Sewer Excav Othe~
INSPECTION NOTES
Inspected Date 8- ( 3 -0 3
Remarks 4... TeLL tto Ie ( n
Time g ~ ~V~ By j)etltL{{S E
3/~ c;CJ.J v ~( ~
RESTORATION REQUIRED
YES
NO X
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bro~~ RJL
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt
OPCC
o Other
70 3&,
D Repaired by City
[] Repaired by Permittee
D No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty 01 IJort Angeles
Public 'V orks Departnlent
"T ater Distribution Repair Report
HTe (JJ F 7 J-.( 1..
IWork Order No'
72/2-
,
ICrew VeKJ-US ~, ~I<: F /
DATE REPORTED 7 - zS' <:> S
CONDITION ErvlERGENCY D ROUTINE D CITIZEN COMPLAlNT )&
LEAKAGE SURVEY D OTHER D
DATE OF REPAIR. 7 - 2&,.-03 TIME 2- DA.M. ~.M.
REPAIR LOCATION ADDRESS goo <j5ro-JiA- ~
TYPE OF MAIN 6a.l v ~ SIZE ~f (t'
DEPTH OF MAIN 2. I CLOSEST VALVE DEPTH. :5 ('
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL. 0 LONG BREAK 0
HOLE)! CLAMP 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITTING 0
METER SETTER 0 rvlETER D
LINE VALVE. FLANGE NUTS/BOLTS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLAMPO DRESSERO OTHER ~ ~1f1 ~ S u~ p e I,r-e-
SITE CONDITION GRA VEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA}4 SOIL TYPE
CUTS ASPHALT CUT _IT CURB CUT _IT SIDEW ALK _IT
DRIVEWAY CUT _IT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE )!.
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE p(
CHLORINE RESIDUAL SAMPLE tJ //1 P.P.M.
I
WATER OFF FROM II :>DAM. TO Z (J M.
FROM
M.TO
M.
APPARENT CAUSE OF LEAK. 0/ d A~
CIty 01 IJort Angeles /+Te w ~ 7 '13 ~
Public 'Vorks Departnlent
"Tater Distribution Repair Report
IWork Order No 7q sCo
I Crew Dc"'....,<; E. .A So~\ . M ]";4 G
DATE REPORTED ,8 ~ ("541'D ~
CONDITION ErvlERGENCY ~ ROUTINE 0 CITIZEN COMPLAlNT ~
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR.
S - n -0 ~
TIrv1E 8 so
DA.M. ~.M.
REPAIR LOCATION ADDRESS ,?-OD i)rcvVV\.. RQ
TYPE OF MAIN
~ Ge;:.J v'
SIZE 3/c{ Ir
DEPTH OF MAIN
2(
CLOSEST VALVE DEPTH.
3(
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL. 0 LONG BREAK 0
HOLE ~ CLAMP 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE. FLANGE NUTS/BOLTS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLAMP){ DRESSERD OTHER
SITE CONDITION GRA VEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHALT CUT _IT CURB CUT _FT SIDEWALK_IT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING V""L{ (~ TUBERCULA TION-MINOR 0 SEVERE K
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE ~
CHLORINE RESIDUAL SAMPLE tJ A P.P.M.
WATER OFF FROM 7;"30 {J M. TO & WPM.
FROM
M.TO
M.
APPARENT CAUSE OF LEAK. 6(; a.~