HomeMy WebLinkAbout430 E 9th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
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REQUEST
Date I - (1- 0 '5
Time /0 A t/V{
Received by iJe"1.VlI S ,~ (phone, person!
Location of Work to be inspected .,. '-/30 j: C) -tl..
Name of person requesting inspection Pe 1-'11'1 " s E
Address of person requesting inspection 6.--p YG\.rJl II ~ & Phone No '1/7-f(8-t/~
Type of Inspection (circle appropriate one) I Permit No., .)
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Othe~-'\.-f ~)
INSPECTION NOTES
Inspected Date I - I 1- 0 5'
Remarks ;{ e IJc--.., or z..' L, T
I
i PM.
Time ~ By
P"I/t.4 I V\ b (- e t:.\ k. W 1+ L.
O(Vlv\I'S E
c" 5 S - r p j),:\ 1'1 b"1l/\d
~
2 .555 ~q~
J i~. <:'l....."\oQ
~ Cqr iec."- ClVl v,-dve.?t+ .5 vV. c (.) r
Pe ,,-be d'-J' CA..-l So .
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RESTORATION REQUIRED
YES
NO X
~
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Re!Alf"e.d rC'-Lk.1f\ b
( 0''\ k <:'\./ :5>()
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
[] No Damage Found
Work Order #
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 gc 3'1:l...-6cS-
lerew. 7/~ &\i^.C'J c<ret,J
]
DATE REPORTED I -- i I - 0 S
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN CO!vIPLAINT 0
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR.
i -, (-Os- TI1vfE 10
ADDRESS '/ 30 E-. ~1-t~
~.M. DP.M.
ci-. V td v e.. c" t 5 IAJ
c1~
(, r..?('iI\-i(,'
~. V ( V\...L
REP AIR LOCATION
TYPE OF MAIN
i,
c.. - r SIZE. Z
-::> I
J CLOSEST VALVE DEPTH.
( ,.
L"2.
DEPTH OF MAIN
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK %... SPLIT BELL 0 LONG BREAK 0
HOLE 0 CL~ 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE FLANGE NUTS/BOL TS pi( STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTHER.
COMPONENTS OF REP AIR. CL~)( DRESSERO OTHER
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWAI,K.q CURB 0
TOP SOIL AREA 0 SOIL TYPE lVi''\. fr v~
CUTS ASPHAL T CUT _FT CURB CUT _IT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING Ai A TIJEERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE ^fA P P M. r::~)C ed 1/ v' e...-
WATER OFF FROM M. TO M.
FROM
M. TO
M.
APPARENT CAUSE OF LEAK.
6r dv~ 5ctfle...-