HomeMy WebLinkAbout934 W 13th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . INSPECTION REPORT. . . . . .
REQUEST
Date 12... (2- ---04
Time
10 AM
Received by OeVlVll<S C ~hone'fll1~/
Location of Work to be inspected Cj 3 '-{ tV
Name of person requesting inspection tJe.1/I. v\ ; ">
Address of person requesting inspection ~ ,/" ,tJ
I
Type of Inspection (circle appropriate one) Permit No-~
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav ~;--t:J-'\...,fe r ~
'3~
I -
C-
YA.r~
Phone No 'f (1 -'I 8'-l q
INSPECTION NOTES
Inspected Date I '1.. - i 'Z- ~ '-f Time /;J W'L By ~kh (s E-
Remarks ;<ef4..~-r 2 rr C Y ~I'v'\ b ~~"'-k" w (+~ ~ 5+4..( vt le.ss Sk.e.tl
Y'-c y(Ja.. I .(' bA.V\.d Z . s 8 - 2 G:, ~ r c;... VL~
,
RESTORATION REQUIRED
YES
NO >'-
I ; ~ J
L_
--,--'.~----_.~.., .
~ 0 -r4.
I 3'- ~\
::.
k 8D , (
,V ~ 2" (
C 'I 'Sz Deep ----0
;;;
,j C\Q
~"'~'"'~~.~'._.....-._"._~.",,,.,._-."._----~.~-,,._..,_. -_._.~
Cj3L(
w j 3+!::: j
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
D Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # 1.3 ffz 8' - Ot..{ 0
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 (:5 ~2 8-0'+0
Icrew 1(s,? CretJ
]
DATE REPORTED 1'2- -tZ ""'oLf
CONDITION E1vfERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT ~
LEAKAGE SURVEY 0 OTIIER 0
DATE OF REPAIR. I Z -l-z.. ....Dtf TIME
REP AIR LOCATION ADDRESS
Q3'-(
0.
(
3ft...
I -
DA.M. ~.M.
TYPE OF MAIN
c,r
Z(f
SIZE
( (
DEPTH OF MAIN :3 'Z. CLOSEST VALVE DEPTH. 3
COMPONENT REPAIRED.
MAIN JOINT D CIR. BREAK'~ SPLIT BELL D LONG BREAK 0
HOLE D CLAMP D OTIIER
SER\lICE TAP D CORP STOP D PIPE D CURB STOP D FITTING 0
METER SETTER D METER 0
LINE VALVE. FLANGE NUTS/BOL TS D STEM 0 BONNET 0
HYDRANT BRANCH D VAL VE D BARREL D
OTHER.
COMPONENTS OF REP AIR. CLAMP)( DRESSERO OTIIER
SITE CONDITION GRA VEL 0 ASPHALT D SIDEW 4LK lJ CURB D
TOP SOIL AREA J( SOIL TYPE ~+( ve..
CUTS ASPHAL T CUT _FT CURB CUT _FT SIDEWALK_FT
DRlVEWAY CUT FT
MAIN CONDITION INTERNAL LINING tJ(A TUBERCULATION-MINOR 0 SEVERE D
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE D
CHLORlNE RESIDUAL SAMPLE ~ /A P P M. F,;< e J {, U L .
WATEROFF FROM ~ M.TO ~ M.
FROM M. TO M.
APP.i\RENT CAUSE OF LEAK
6y-ov~ ~*(e..