HomeMy WebLinkAboutCampbell & Wabash Ave - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . INSPECTION REPORT. . . . . .
REQUEST:
Date II - Z-04
Time'-f: '2-0 f?1o-\. Received by 0<....."',,<; E. (phone. person)
Location of Work to be inspected 6-.A b-e.ll Ii J €. cjl- I.Jtt t?^-s Ire
Name of person requesting inspection ~~- ~-" Vevt.vl <'s F
Address of person requesting inspection (,) '10.. r & I i Of- IS Phone No.
f
Type of Inspection (circle appropriate one):
Lit'? -<f8<t"l
Sewer Foundation Framing Chimney Plumbing
Final
Permit No.
Sewer Excav. O~"'-+~ '7
INSPECTION NOTES:
Inspected: Date II - Z - o<{
Remarks: ~e,(}c..I:,r 2" CT.
t
Time
t-vlo.., VJ
2; Zo PM. By DevtvLlS
bre~ k
c.
RESTORATION REQUIRED . . . . .. YES
6M~bdl Av'e
z" ~:r. 40.
~C'J(-"'"
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel
o Repaired by City
o Repaired by Permittee
o No Damage Found
~
VI
~
~
o Asphalt 0 PCC 0 Other
Work Order # 1.3 &' Z & - 0 gz
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necess~.y:)
-- -------
~
City of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No: /382 8 ~05L..
lerew: 7(5 -r Cr.
DATE REPORTED:
If - z -C><.{
CONDITION EMERGENCY)( ROUTINE 0 CITIZEN COMPLAINT 0
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR: II -'Z-r-O '-f TTIvlE If: 2-D
REPAIR LOCATION ADDRESS-.! 3 S-8 c.c......1.obe ((
If'
C - L. SIZE 2
;
CLOSEST VALVE DEPTH: 3 ~
DA.M. ft(PM.
1'/ ve... .
TYPE OF MAIN:
DEPTH OF MAIN:
'1
COMPONENT REPAIRED:
.,
MAIN: JOINT D ClR. BREAK i2l... SPLIT BELL D LONG BREAK 0
HOLE 0 CLAMP D OTHER
SERVICE: TAP D CORP. STOP D PIPE 0 ClJRB STOP 0 FITTING D
METER SETTER 0 METER 0
LINE VALVE: FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT: BRANCH 0 VALVE 0 BARREL 0
OTHER:
COMPONENTS OF REPAIR: CLAMP)( DRESSERD OTHER
SITE CONDITION: GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUtS: ASPHALTCm _FT. CURBCm _FT. SIDEWALK _FT.
DRlVEW A Y cm _FT.
MAIN CONDITION INTERNAL LINING N. A . TUBERCULATION-MINOR 0 SEv'ERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORlNE RESIDUAL SAMPLE . <II PPM
WATER OFF' FROM
6 P M. TO
7 r:J M.
FROM
M. TO
6rz:>u.....J
M.
-5e.-tf-1 c
APPARENT CAUSE OF LEAK: