HomeMy WebLinkAbout4314 S C St - Engineering
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CITY OF PORT ANGELES. __~
DEPARTMENT OF PUBLIC WORKS I / ~, ~- /
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date S - J D- :2.u {J ( Time
Received by
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
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Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other lJJ c:c-t-eJ-
INSPECTION NOTES
Inspected
Remarks
Date
Time
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RESTORATION REQUIRED YES
G'-eY\ rt LJ6D~
~' cur$of
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SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel
D Repaired by City
[] Repaired by Permittee
D No Damage Found
o Asphalt 0 PCC I 0 Other
Wor~rder # fjlf r
~COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . . .
REQUEST
Date 7 ~2-",> --0<f
T -':00 A i.A /1"" J.-
ime ~ ...~~ Received by I/tk,^ I co,:- (phone, person)
.1 lIlI (
Location of Work to be inspected 13t'f :3D Clv\...Q.+er bo;<. /oca..te.cl a... [)lAe.r 0.\
.. .)-....~ r L s"t-E)(T-1-6IeiAWDod
Name of person requesting Inspectlon!...-K v~.v\ \ '!7 c::...
Address of person requesting inspection Corf) Va.rJ n~ q, ~ Phone No
I
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Oth~'
INSPECTION NOTES
Inspected Date ?~ 2.3 r 0 '+
Remarks rSxed ServILe 1C:a.K
l 3 ( C) \- pol 'j b.: + y( e ilL e w', -+ l.
Time q \ 00 A l-v\ By
6 fA.... (c..... ~C)"V\.' V\.:) .s ~Je
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I ~itt V\. (S (;:-
lye: -.5'ervlCQ . RQplQ~ed
RESTORATION REQUIRED
YES
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6' !e~(t-Vuad A U (-"
g I'A c.
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
NOX
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\(
\.-0
,,-'
'J)
,
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o Asphalt 0 PCC 0 Other
Work Order # fc{Z7'8 -cY-(C::>
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
(DATE)
STREET SUPERINTENDENT
City of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No 1'/1-:7?[ -0'4(0
I Crew' 7'':;; ~ Gv --e t-J
DATE REPORTED 7. - 20 - 04
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT ~
LEAKAGE SURVEY 0 OTI1ER 0
TYPE OF MAIN
7 - 2"5 ,-ot! TIME q ...00 ~.M. OP.M.
ADDRESS Lov b\ e;(" 6.r; 6 (eK eJood ~ C s+ ~ xf-
A/' Q(f
_ <-- SIZE. C)
DATE OF REPAIR.
REP AIR LOCATION
CLOSEST VALVE DEPTII.
,--
DEPTH OF MAIN
COMPONENT REF AIRED:
MAIN JOINT 0 cm. BREAK 0 SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE. TAP 0 CORP STOP 0 PIPE)( CURB STOP 0 FITTING 0
:rvtETER SETTER 0 METER 0
LINE VALVE. FLANGE NUTSIBOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
OTIIER.
CONtPONENTS OF REPAIR. CLAlvlPO DRESSERD OTHER PIE- -tuh':J i- Iu.'"ir S-t-bi
SITE CONDITION GRA VEL 0 ASPHALT 0 SIDEW AJt.K 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE IJL tA- -f I li/ e...
CUTS ASPHAL T CUT _IT CURB CUT _IT SIDEWALK_IT
DRIVEWAY CUT _IT
e:t<;.,e "" b
MAIN CONDITION INTERNAL LINING tJ / A TUBERCULATION-ivlINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE ~P.P.M.
WATER OFF FROM 8.t4 M. TO 9 It M.
FROM
M. TO
M.
APP.'\RENT CAUSE OF LEAK.
OlcP 4:JL
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT . . . . . .
REQUEST
Date I L ..... ~ -oy:
Time Z 50 Fk. Received by De.......q I..., E (phone, person)
Location of Work to be inspected 4 ~ i '-l
Name of person requesting inspection Del/\. '^ ~s
Address of person requesting inspection 6--v- f
Type of Inspection (circle appropriate one)
~
LXI-
c
6-
Ya..rd.
Phone No 4 (, - l{ 8 <.{1
Permit N(ff ~
Sewer Excav Othe tJ6-.. +e r .
Sewer Foundation Framing
Chimney Plumbing Final
INSPECTION NOTES
Inspected Date /2, & 0 '-f
Remarks $.erV(c e. re (DCa- +e
Time
c-::.. V\....d
LI,'"Z{) Pi.. ^ L'
-,,, 'v'- By -J-Jt?vt ""- I S ~_
t , e.. - I iI\..
RESTORATION REQUIRED
YES
NO )<
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SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel
D Repaired by City
o Repaired by Permittee
o No Damage Found
D Asphalt D PCC D Other
Work Order # /3 go g - :SZ.1
o COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Departnlent
Water Distribution Repair Report
bw - 2.00 7- (8<t1
IWork Order No: /1l( Cf
ICrew- --; I C(
DATE REPORTED ,- /6 -- ?--DD (
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT ~
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR. ~ - /6 - R t D (TIME/:; A- )1/\.. DA.M. DP.M.
REPAIRLOCATION ADDRESS 4t 3 I V cst -e Xt-(
TYPE OF MAIN q < I ,4 C- SIZE
C--/~1111 (jJ 60,J ~
C ~+ -ex-l- j
DEPlli OF MAIN
CLOSEST VALVE DEPrn.
COMPONENT REPAIRED:
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL. 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER /
SERVICE TAP 0 CORP STOP 0 PIPd CURB STOP 0 FITTING 0
METER SE1TER 0 METER 0
LINE VALVE. FLANGE NUTS/BOLTS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVED BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLAMPO DRESSERO OTHER
f;f
flr~
.
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOn.. AREA 0 SOn.. TYPE
CUTS. ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRlVEWAYCUT _FT
MAIN CONDITION INTERNAL LINING TIJBERCULA TION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE I ,tJ' P.P.M.
WATEROFF FROM b k1f\M. TO ~ j}11'\M.
FROM
M.TO M.
f3 r-( HI.-e ~f c f//P-.(Z (
APPARENT CAUSE OF LEAK.
OCT 11 2004 10 45 FR TRRFTON B
253 471
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Tt'I~ Crty ol Port Angeles F:.u:: 360-417470~
From: Qwes1 Communication!> Date~ 10/1112004
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OCT 11 2004
10:45 FR
TRAFTON B 253 471 1324
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13604174709
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p~~n"'d.-53597, 5/3(,
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P.02/03
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..PPlICATION i. h...by m.d' to llle muniel9ility or PORT ~
"craa heroon and l;IS ,,.how,", on ::ltl:u:t1l5d dr;aw&lIJ:
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10 pe,form w,ork U
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The "lim"rod limo rot'compl"io. oflh. abo.. worl: 1. fD "1:JaYS
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THE,ABOVE APPtTCAT!ON (S HHR!!llYGRANTED SUBJttT TO Al'l'UCANT'S;
Co"'plYing WlllI ~ll Muni<rPQI Ordin.n...;
Notifyini lh. SlIcCI SUPcrinl~ndcnr or 1110 rim. the ....ork -wijl.I.o.I"~.nd when lr w.Ill'nnioh::
PtouJ;:'U(lnt the wurk ......h~ o.i1ip-ru;:c oIlJd with due rnpe.1C't to all pr.oI~C!lrty, \:gnttac;lu. pORoDa.'
rie,hu and [he inte,.~n il.nd cQ'ntt~T\ienct: r;;It thr. pl.lbLlc; ,
Slil.ving [ht;l M t,mjcLpHJlI'Y hsm:'iJe'ls "(lorn any arid a..ll dam.,e, which rrtay l!IeeNO tQ 3.nY:f1Il!~i1
or pr"l'erry hec:aU.lif of rhu inrtlllatlon or tl'le mli,.t.enanee 'tl'l.e~f:
Complylnil'.""ith: (C111owina: ""I!otlll ~O!ldtIl'aN~
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OCT 11 2004 10:46 FR TRAFTON B 253 471
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1324 TO 13604174709
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** TOTAL PAGE.03 **