HomeMy WebLinkAbout1755 E 6th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT . . . . . .
REQUEST
2 - 2'1 - o~
Date
Time 5" - >0 PIvt... Received by () e ..'\. Vt , S
(phone, person)
-----....
Location of Work to be inspected I 7 ~ '5- E C:, 7f. S-t-
Name of person requesting inspection O-e Yl rl '5 6""
Address of person requesting inspection ~J!) V&Il,,-d I 7 of tl3 Phone No lf/7 -'-(;>'19
Type of Inspection (circle appropriate one) I
Sewer Foundation Framing Chimney Plumbing Final
Permit No ..."_
Sewer Excav Oth~~+0
INSPECTION NOTES
Inspected Date 2 - Z if -0 5
Remarks Reoa. I r z' c -L
.,
~v1. d SL t:. 80 fJ-v c-
Time ~ oS D (JM.. By VeVtVl I S E-
M4.,V\ b(""'~~k. w/'+"'- L dre~<;e( CCJp/ltl.jS
RESTORATION REQUIRED. .
YES
NO X
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~
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(;' AC- 1/ Z' L"L.J'! c-.
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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
Work Order # ~034 z.. r-OLD
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No 3q31.{Z- - OZD f
JCrew ({ S- ~ C'QJ..U
J
DATE REPORTED 2 - 2 t/ ,O~
CONDITION E1'v1ERGENCY 0 ROUTINE 0 CITIZEN CO.tv1PLAINT 0
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR.
:L -7..4 -05
b
ADDRESS I 7 -S- "!) C ~-l~
c.... - r - SIZE. 2 "
TI1vlE
DAM. ~.M.
REPAlR LOCATION
TYPE OF MAIN
( r
DEPTH OF MAIN 2 --z.. CLOSEST VALVE DEPTII.
tJ _A
COMPONENT REF AIRED.
MAIN JOINT 0 CJR. BREAK D SPLIT BELL 0 LONG BREAK 0
HOLE /'i. CLA.tv1P 0 OTHER
SERVICE. TAP D CORP STOP 0 PIPE 0 CURB STOP D FITTING 0
METER SETTER 0 METER 0
LINE VALVE. FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH D VALVE 0 BARREL 0
OTHER.
COMPONENTS OF REF AIR. CLA.tv1PO DRESSER)( OrnER S c..l g D P-V. L Z
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK D CURB 0
TOP SOIL AREA)it: SOIL TYPE
CUTS ASPHAL T CUT _FT CURB CUT _IT SIDEWALK_IT
DRlVEWAY CUT _IT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE Z'-I p P M.
WATER OFF FROM 5- <./5 PM. TO (;;, ;:7 M.
FROM M. TO M.
APP ARENT CAUSE 0F LEAK. () {tJ o..~ _ e (e c.:.. +~ 6 { I"" ( '?