HomeMy WebLinkAbout1804 W 4th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST'
Date / - J 7- 05-
Time
c-' -.
I c/?.; /} """ Received by
7/;
(phone, person)
Location of Work to be inspected J fiele; ?J c-I/L.
Name of person requesting inspection (.A.../c<:: t er 0, v
Address of person requesting inspection /7 0 -.3 5' 0 13
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing Final
Phone No '-1/7 tj~Y7
Permit No
Sewer Excav ~lhe;.., C-Jczl <'? .,,-
Inspected
Remarks
INSPECTION NOTES
J -). )- 6 S-
Date
Time 9 30 4/~7 By 7/"/
3\\ LJ /J1/tN\ (5/~Pff
t 'e f)~ fI" e ~ tv / T h ,55 I e LJa 4/ ih ~ <" {
, ,
RESTORA TION REQUIRED . . . . .. YES /Y NO
I I .*
.
./
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~ ,\ L.... r Jr.;--/6 '-1 If/A
AI .-
- I
/-
I I
- "
<./'
-\
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
o Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC IftOther T~) 5(;"'1/
Work Order # 'jo3v"J." 0/'/
.
o COMPLETE
~ INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
City of Port Angeles
Public Works Department
Water DIstribution Repair Report
IWork Order No ~ G? 3 ~~ -. t:J 1,/
Icrew Ill} 7/~ 7J.)j 7) ?
DATE REPORTED J-;< <) -0)'
.
Co.NDITIo.N E1v1ERGENCY 0 Ro.UTINE 0 CITIZEN COMPLAINT ~
LEAKAGE SURVEY 0 OTHER 0 /'
J -J J -D ) q' -0 ftA.M. OP.M.
DATE OF REPAIR. TIME (v
REP AIR Lo.CA TION ADDRESS J <80<1 k/ <-/'<-
TYPE OF MAIN C:1 SIZE ;Z 1\ -
DEPTH o.F MAIN J ) CLo.SEST VALVE DEPTH. "3 )"
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK ~ SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLANW 0 OTHER
SERVICE. TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITTING 0
:METER SETTER 0 :METER 0
LINE VALVE. FLANGE NUTS/Bo.L TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
o.THER.
Co.MPONENTS OF REPAIR. CLANWO DRESSERO OTHER "'S5 ~~J4I'r (;a /I d
f
SITE CONDITIo.N GRA VEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA ht' SOIL TYPE
CUTS ASPHALT CUT _FT CURB CUT _IT SIDEWALK_FT
DRlVEW A Y CUT _FT
MAIN Co.NDITIo.N INTERNAL LINING /l/ II TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSIo.N LOCALIZED 0 EXTENSIVE 0
CHLORlNE RESIDUAL SAMPLE AI;l P.P.M. ;2 rIal e J vvlcJ"1 !()(/I,I/C" f [esjuf'e
WATER OFF FRo.M o{fD 4 M. TO. C{ t7D /1 M.
FROM
M. TO
M.
,\PPA..RENT CAUSE OF LEAK.
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