HomeMy WebLinkAbout132 E 13th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQU~T . .-1
Dated--- r -- () 1
Time
Received by
(phone, person)
Location of Work to be inspected /J. ~ E 13~r!l
Name of person requesting inspection I f..A...) I f u f (;>
Address of person requesting inspection / 7.11[ f- L-?
Type of Inspection (circle appropriate one)
Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other l.A...JC{~
INSPECTION NOTES
Inspected Date
Remarks
Time
ReFOl/r-
., , .
C 0 ~/' r:? ,),-17} i-?
'/ 1/
By
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RESTORATION REQUIRED
YES
/
NO t/
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt
D Repaired by City
[] Repaired by Permittee
D No Damage Found
o PCC 0 Other
Work ~r # ,~;;-6 ~ 2-
~MPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
City of Port Angeles
Public 'Vorks Departnlent
"1 ater Distribution Repair Report
r/-k v..;(:./f SO 4-L
IWork Order No. S6 ~/ ~ ICrew /1 C;
DATE REPORTED- .{,.---t7 --0 I ./
CONDITION EMERGENCY 0 ROUTINE 0 OTIZEN COMPLAINT V
.lEAKAGE SURVEY D OTHER D
DATE OF REPAIR. 6 - '1'-- G;; TIME DA.M. DP.M.
/,;;2- E- /3-11
REPAIR LOCATION ADDRESS
TYPE OF MAIN
-2"CC-~ SIZE
DEPTH OF MAIN
CLOSEST VALVE DEPTH.
COMPONENT REPAIRED:
MAIN JOINT D CIR. BREAK D SPLIT BELL D LONG BREAK D
HOLE D CLAMP D OTHER /
SERVICE TAP D CORP STOP ~E~URB STOP 0 FITTING D
METER SETTER 0 METER 0
LINE VALVE. FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH D VALVE 0 BARREL D
OTIIER.
COMPONENTS OF REPAIR. CLAMPD DRESSERD OTIIER
SITE CONDITION GRA VEL 0 ASP~D SIDEWALK 0 CURB 0
TOP SOIL AREA ~ SOIL TYPE
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE :!iLP,P,M.
WATEROFF FROM J /,30 IL, TO 2 f~;;::.
J .(),tdr
) cAuVC/1 ;;~r(
uJ~
FROM
M. TO
M.
APPARENT CAUSE OF LEAK.