HomeMy WebLinkAbout312 Columbus Ave - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST
Date ( - 10 -" Cff
Time 2 rJ M.
,
Received by D- EJj("L5t-o"~~hone. person)
Location of Work to be inspected .3 iz... CDlu~", ku,:> Au€-
Name of person requesting inspection ~ _ Ed,)' ~ c~
Address of person requesting inspection Lor p c~.r &.
Type of Inspection (circle appropriate one)
Sewer Foundation Framing
Chimney Plumbing Final
Phone No
Permit No r::..
Sewer Excav Ot~tck.+<: 0
INSPECTION NOTES
Inspected Date I - (0 .- 0 q-
Remarks f2 e .14 I .r Z ~ c- r
J
Time
.
-5 /~ ~ . . By D E~ rv':3-to..--
w .f {. '5 s .f ul( c. r<:- (e Ire /J6...t -r bc,,-,,d
- 3
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J/Vl-tA. i V"\..
RESTORATION REQUIRED
YES
NO .x
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L
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V)
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SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
D Asphalt D PCC C80ther Dec<.1 ,c,i I v'~
f!-o <:-K..
Work Order # f3iSz.8'-005' No r~",to -~tIC.,
o COMPLETE ~~e.je.c\
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Department
Water DIstribution Repair Report
'Work Order No I 3 g' 2.8 - 005"
I Crew 7 (5'"'
J
DATE REPORTED I - {O .- o<-f
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT ~
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR.
I - t 0 .- 0'1 TIME 5
ADDRESS 32 ( Gt VI.1A. b;)5
DA.M. p:P.M.
AJe.
REP AIR LaC A TION
TYPE OF MAIN
L. T-
o r
if
-:? Ir
SIZE L-
2' 38 oD
-/
tj
....
DEPTH OF MAIN
CLOSEST VALVE DEPTI:I.
COMPONENT REPAIRED.
MAIN JOINT D CJR. BREAK):( SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE TAP D CORP STOP 0 PIPE D CURB STOP 0 FITTING D
IvfETER SETTER 0 METER 0
LINE VALVE FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH D VAL VE 0 BARREL D
OTHER.
COMPONENTS OF REPAIR. CLAMPP( DRESSERO OTHER
SITE CONDITION GRAVEL 0 ASPHALT D SIDEWALK D CURB 0
TOP SOIL AREA l'i:r SOIL TYPE tVc....+t J e C (.... .../
CUTS ASPHAL T CUT _IT CURB CUT _IT SIDEWALK ~FT
DRIVEWAY CUT _IT
MAIN CONDITION INTERNAL LINING rJ IA TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE .:3 ( P.P M.
WATER OFF FROM
;1. fJ
I M.TO
~ ~ ltJPM.
FROM
M.TO
M.
xTH e...
APPARENT CAUSE OF LEAK. ~y"1?vvJ