HomeMy WebLinkAbout521 S Cherry St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST ~
Date J --1-2> ?
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)
s-;z I .5. Ch-Pl~Y
/Vv/l c~x /
/ ( r/ l 1:/-- IJ P~one No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other iN ~/~
INSPECTION NOTES
Lv ( tI\
Time By
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I : l v-c / --{J ? (A 1/\ ~o ;
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Inspected Date
Remarks
RESTORATION REQUIRED
../"
YES ~ NO
2" tI/--( Nt
li- I 2.< ( ~y
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~\
/, -f1
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,
\
\)
SURFACE RESTORATION \
-
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other / ~r ~ Co { L
Work Order # /5 Y 1- 6 - (j::.) ';:
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Departnlent
Water Distribution Repair Report
IWork Order No
, Crew
'(1 V
(
DATE REPORTED
CONDITION E1v1ERGENCY D ROUTINE D CITIZEN CO.MPLAlNT D
LEAKAGE SURVEY D OTHER D
DATE OF REPAIR. /-?f -0 t..j TI1v1E --; It YJI\.. DA.M. DP.M.
REPAIR LOCATION ADDRESS I ~:2. ( S' C )z ~ ?ry.
TYPE OF MAfN ? ( I (C .r---- SIZE /
DEPTII OF MAlN
CLOSEST VALVE DEPTII.
CO.MPONENT REPAIRED. /
MAlN JOINT D CIR. BREAK4:rSPLIT BELL D LONG BREAK D
HOLE D CLAMP D OTHER
SERVICE TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITTING 0
1v1ETER SETTER 0 1v1ETER 0
LINE VALVE. FLANGE NUTS/BOL TS D STEM D BONNET D
HYDRANT BRANCH D VAL VE 0 BARREL 0
OTHER.
COMPONENTS OF REP AIR CLAMJ>~SSERO OTHER
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK D CURB D
TOP SOIL AREA D SOIL TYPE
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR D SEVERE D
EXTERNAL CORROSION LOCALIZED D EXTENSIVE D
CHLORINE RESIDUAL SAMPLE I P.P.M. N-e ptU 'r41 U)1 el-€ V r f--e <;;;0 r ~
WATER OFF FROM M. TO M.
FROM M. TO
M.
f-e If / --P c~
JJ~(?[pt
'-
APPARENT CAUSE OF LEAK.