HomeMy WebLinkAbout1704 E 4th St - Engineering
City of Port Angeles
Public Works Department
Water DIstribution Repair Report
IWork Order No /3ffzf? --Oz.:?!
I Crew 7 '5 <=>i-- C r -e;.J
DATE REPORTED ij'.- (Cj , oc..(
CONDITION ENlERGENCY D ROUTINE 0 CITIZEN CONlPLAINT)t[
LEAKAGE SURVEY D OTHER 0
DATE OF REPAIR. 9 - 3 "04 TIME :5 So DA.M. ~.M.
170L{ F .ft..
REP AIR LOCATION ADDRESS t.f -
TYPE OF MAIN C r. SIZE 2-" ""-
r r
DEPTH OF MAIN 5 CLOSEST VALVE DEPTH. 3
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK D SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE. TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITIING 0
:METER SETTER 0 :METER D
LINE VALVE FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH D VAL VE 0 BARREL 0
OTHER. ~e-fc;.y /IVLe 50 ('i-~ I/lO t Ur"d er h~{ Ie ~ ~ ) le~ k-Il,,')
COJ\.1PONENTSOFREPAIR. CLANlPO DRESSERO OlliER SLk 80 PJL/ /Jresser LOJf(L~S
SITE CONDITION GRA VEL 0 ASPHALT)1 SIDEW ALK D CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHAL T CUT ~FT CURB CUT _IT SIDEW ALK _IT
DRIVEWAY CUT _IT
MAIN CONDITION INTERNAL LINING 60D c:{ TUBERCULATION-MINOR C SEVERE 0
EXTERNAL CORROSION LOCALIZED D EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE
if
P.PM.
WATER OFF FROM <(5 A fl1/'tf. TO loA M.
M. TO
;0/4
I
FROM
M.
APPARENT CAUSE OF LEAK
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . . .
REQUE~ '~/-""OY 7 Abvt..
Date q Time ~ ~
Received by.lJeK"'- IS ,=
(phone, person)
Location of Work to be inspected I 70 tf E, <-f~ s.-R-
Name of person requesting inspection Devto-t i 5 E
Address of person requesting inspection ..::.0......0 Ya..r d (7 <>t- 6 Phone No
I
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other u.J4-.+e ~
INSPECTION NOTES
Inspected Date CJ - 5 r 0 't
Remarks Ke -I c........../2" II V\..e /Vl TO
4 '-r~( { hut JL~~ ~k(l~
r e '-, I r Ke. .ct ""- ~l-V\. qlr\. Set $(':./' v I c.. e-to -r'^e. w
LD^c..ir-e.tC. Jlk ~c.... ~ 5cvtk D'~' Side.. t..UcJk
',/0 hul k k~d r-eJ ,,)C.ed +D 5./(.( PE ~VlJ re COv(Yl~~eJ -rD
RESTORATION REQUIRED YES X NO
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c
t/-~' Deef
Z" C T
-0
,
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...
0-
14
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8" c.CiDO L L/ -+~ ~t
Oldjll;t~i
DIJ. ~8V.,-e
I IN.. ..'
-......---_.....
.c/k 80 /),,1,- f"c\
J~ VLe.<.v r1G.-+,uv~_
31'-{
SURFACE RESTORATION 3( x.~D' \(.<-..... C\-\~-O(
SURFACE TYPE 0 Unimproved DGravel ~ Asphalt 0 PCC 0 Other
CI Repaired by City .Work Order # 13 8zB;. O!; <6 . t
[] Repaired by Permittee l2( COMPLETE ').. '-:)CJ 'U' -t+
[] No Damage Found 0 INCOMPLETE A'f'es..,." ~e..~d~ vJ\lV\
/1'/' I -\- ~ .:t ~ y 0.. \l-o L\
? -LQ ~(1yr::d 9//tJ MlJ;;;
(Continue on reverse side if necessary) STREET SUPERINTENDENT IDA TE)