HomeMy WebLinkAbout1415-1417 E 2nd St - Engineering
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CITY OF PORT ANGELES - A
DEPARTMENT OF PUBLIC WORKS ~j7 I
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST:
Date 3 - .L/-b~
Time
Received by
(phone, person)
)Lfl1- J~() ~ ~ f)..hJ
Location of Work to be inspected )-
Name of person requesting inspection ~\ ,'\ (~
Address of person requesting inspection ___~ :6=J;i- Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other lLJ/{..W'
INSPECTION NOTES:
Inspected:
Remarks:
Date Time By
, ,Q-eP(~ 2 9-. J 'F-f-e~h + 1-- -.'Ae;; ,
i?d/''' :--' .- ,J.j~Y o/M./Yt lAJ-0] ~~d
/
RESTORATION REQUIRED . . . . .. YES f/ NO
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I
"\ ~ ~H G--R\V
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SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
o Asphalt 0 PCC 0 Other 0/ S6 / ' L
Work Order # ;(6 ,~-9
o COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
City of Port Angeles [::>"-' -:z..So /. ~O~-8
Public Works Departnlent
Water Distribution Repair Report
IWork Order No: ;(oS?l
'Crew:
7/Y
DATE REPORTED: J - lj- 6 2-
CONDITION: EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT ~
LEAKAGE SURVEY 0 OTIIER 0
DATE OF REPAIR: :3.- Lj - 6 '2 TIME: ) 0
REPAIR LOCATI0N: ADDRESS: I (/ / 7 f-- I ~ IS-
~J V, SIZE:
r-A.M. OP.M.
e- Ahd '
() I'
TYPE OF MAIN: ~
\ (
DEPTH OF MAIN: I Y:2-
CLOSEST VALVE DEPTH:
COMPONENT REPAIRED:
MAIN: JOINT 0 CIR. BREAK 0 SPLIT BELL. 0 LONG BREAK 0
HOLE )X CLAMP 0 OTIIER ~ 5 -ep-e yz:... 1--f'
J- --e6<..i< 5
SERVICE: TAP 0 CORP. STOP 0 PIPE 0 CURB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE: FLANGE NUTS/BOLTS 0 STEM 0 BONNET 0
HYDRANT; BRANCH 0 VAL VE 0 BARREL 0
OTIlER:
COMPONENTS OF REPAIR: CLAMPO DRESSERO OTIIER
[SOvVl[1 /h.J 5
SITE CONDITION: GRAVEL 0 ASPHi\.kT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA lD' SOIL TYPE
CUTS: ASPHALT CUT _FT. CURB CUT _FT. SIDEWALK _FT.
DRIVEWAY CUT _FT.
MAIN CONDITION: INTERNAL LINING III A- TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE I 31 P.P.M.
WATER OFF: FROM
M.TO
_ J J- '-t;l.e )J6 sA vi !pw Y1
M. h y<'t't I Y
FROM
M.TO
M.
APPARENT CAUSE OF LEAK: