HomeMy WebLinkAbout705 E 5th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . .
07-20f8
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REQUEST '1 / '"
Date c;- ~ - 6 ~ 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)
Sewer Foundation Framing Chimney
/0 S- . E 5-#,
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Phone No
Permit No
Sewer Excav Other LA..I c\. f-r'fl/
Plumbing Final
INSPECTION NOTES
Inspected Date
Remarks
Time
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By
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RESTORATION REQUIRED
YES
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
o Asphalt 0 PCC
~o~der #
c1PCOMPlETE
o INCOMPLETE
o Other
10 C! '5?
.
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Departnlent
Water Distribution Repair Report
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'Work Order No: ~ D 1 ~
I Crew
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1
DATE REPORTED
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CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT ~.
LEAKAGE SURVEY 0 OTIffiR 0
DATE OF REPAIR. 4-)..b - c) 2- TIME. 1,? 6 ~M. DP.M.
REPAlRLOCATI0N ADDRESS 7c S- k >r~
(( -r
? c.. - ~ SIZE.
DEPTH OF MAIN J-.1:1- ( CLOSEST VALVE DEPTH.
TYPE OF MAIN
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL. 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTIffiR
SERVlCE TAP 0 CORP STOP 0 PIPE~URB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE. FLANGE NUTSIBOLTS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLAMPO DRESSERO OTHER
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SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOn.. AREA ~ SOn.. TYPE
CUTS. ASPHALT CUT _FT ~ CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING 11//1- TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE ' 3 '1 P.P.M.
WATER OFF FROM 1, 3b 1iM. TO / lJ fr M.
FROM M. TO
M.
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APPARENT CAUSE OF LEAK.
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