HomeMy WebLinkAbout916 E 7th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT.
REQUEST
Date j- <-/- 0 S
Time
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Received by /) < ,," .'1/ S C- ({phone, person)
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Location of Work to be inspected I (\0 ~. -
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Name of person requesting inspection (/<- v\.V\ ,<, C,'
Address of person requesting inspection Co,' ,/1 ~L/A' / 7 ry...-iJ Phone No <f/7 - <(.y<{)
Type of Inspection (circle appropriate one) Permit No .........-'"'-.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other~)
INSPECTION NOTES
Inspected Date I - -7 - .::1 :)-
Remarks 1< e .-1", d' -:7 'eT
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Time
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RESTORATION REQUIRED
YES
NO )(~
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 # 5u34Z- ~OO'-f
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 50.~ 4'2: 00<+
Icrew /IS- c~ ('.t?.....J
1
DATE REPORTED I - ") - () 5"
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN CO~LAlNT Ii..
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR, I - '}.- () S- TI1vfE c.../. ~ OA.M.~.M.
7 -f_l...
REF A1R LOCATION ADDRESS ~7 (b E
TYPE OFMAlN
C- I
.3
SIZE
Z /
DEPTH OF MAIN
CLOSEST VALVE DEPTH.
.-' f
L-
CO~ONENT REF AIRED.
MAIN JOINT 0 CIR BREAK X SPUT BELL 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITTING 0
:METER SETTER 0 Iv1ETER 0
LINE VALVE FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTIIER.
COMPONENTS OF REP AIR. CLAMP)( DRESSERO OTIIER
SITE CONDITION GRA VEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA X SOIL TYPE
CUTS ASPHAL T CUT _IT CURB CUT _IT SIDEWALK_IT
DRlVEW A Y CUT _IT
MAIN CONDITION INTERNAL LINlNG MA TUBERCULA TION-MlNOR 0 SEVERE 0
EXTERNAL CORROSI01'( LOCALIZED 0 EXTENSIVE 0
CHLORlNE RESIDUAL SAMPLE c 28 P P M.
WATER OFF FROM 3 3:DP M. TO 3' t..ff:: PM.
FROM
M. TO
Cote('
M.
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A,.PPARENT CAUSE OF LEAK.