HomeMy WebLinkAbout302 W 8th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . .
REQUEST
Date
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)
/'
Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected Date
Remarks
Time
By
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RESTORATION REQUIRED
YES
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NO .\
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel fS.1 Asphalt 0 PCC
o Other
o Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
,-
f2] COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
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City of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No. i ""
Reported: ~/ ~/ ~
Repaired: ~/ L._j~
Condition.
Source
Repair Location.
Address
Lac Description.
Component Repaired:
Main:
Joint ~
Long. Break_
Service:
Line Valve:
Hydrant:
Other:
Tap_
Flange Nuts, Bolts
Branch
I Crew:
7 /J ..!
Emergency'/ Routine
Citizen Complaint
Leakage Survey _ Other t..o ~+.,.~. (
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Main Line IDU:
Cir Break
Hole
Split Bell _
Clamp _
Other
Corp. Stop _
Valve
Pipe _
Stem
Barrel
Curb Stop _
Bonnet
Repair Type: Clamp _
Site Condition: Surface
Curb
Damage:
Cuts: Street Cut: Ft.
Dresser ~ Other
Gravel Roadway _ Asphalt Street L.- Sidewalk
Top Soil Area _ Soil Type _
Main Condition:
Diameter"
Material
Depth of Cover'
Internal Lining:
Tuberculation.
External Corrosion.
Special Conditions.
Curb Cut: Ft.
Sidewalk Cut: Ft.
Inches ,"
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Joint Type: Crl (" ( "" .
External Prot:
NfA
NfA
Bedding:
Minor
Localized
Severe
Extensive
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Other Structures.
Samples Taken: Pipe Section _
Coupon _
Water Off- From_I_I_ To ." :,",'_M
From_I_I_ TO_~M
Apparent Cause of Leak:
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5/19/98
Pagel
PW-902.09