HomeMy WebLinkAbout414 E 6th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST
Date / - 5 -oL{
Time
'-/ tfS-
Received by Uevtk \ ') i~ (phone, person)
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F
- -
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Location of Work to be inspected f ( t-( E
Name of person requesting inspection l) e Vlvt I S
Address of person requesting inspection CD'~ IJ
Type of Inspection (circle appropriate one) I
Sewer Foundation Framing Chimney Plumbing Final
INSPECTION NOTES
Inspected Date I ~ ~ - Dc{
Remarks ke!{~q r ecJ Z (I C _ T..
Time
/1A...c.... ( n
Phone No ~ ( 7 - of 841
Permit No -
Sewer Excav Ot~~
} 15 By oevt~ ,S'=-
cJ/{u( ( <:: ~,- c I ~ re ~c,-'/ (' tK,,/I\..cL
( I
RESTORATION REQUIRED
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~
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~ -
--B c
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~ f- III ... ~
-0 "S
I L(ltf ttA..
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YES 'X' NO
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt
o Repaired by City
[] Repaired by Permittee
o No Damage Found
OPCC
o Other -r;;;JSG l" l
I
(3G 57
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No ! 34>3 cr
'Crew PeK~I~ E/ J;CS(/Vl (-~ ~uAl
DATE REPORTED
I ~ 5 -at/-
CONDITION EMERGENCY D ROUTINE D CITIZEN COMPLAINT )(
LEAKAGE SURVEY D OTIIER D
DATE OF REPAIR. /-..:? -0 Lf THv1E Lf tf~
REP AIR LOCATION ADDRESS '-f (L{ E ~ +~
DA.M. ~.M.
TYPE OF MAIN
CL
SIZE
2 (I
( I
2...-'"
'2-.
CLOSEST VALVE DEPTH.
( (
22
DEPTH OF MAIN
COMPONENT REPAIRED.
MAIN JOINT D CIR. BREAK)?[ SPLIT BELL D LONG BREAK D
HOLE D CLAMP D OTIIER
SERVICE TAP D CORP STOP D PIPE D CURB STOP D FITTING D
METER SETTER D METER D
LINE VALVE FLANGE NUTS/BOL TS D STEM D BONNET D
HYDRANT BRANCH D VAL VE D BARREL D
OTHER.
COMPONENTS OF REPAIR. CLAMP)Q" DRESSERD OTHER
SITE CONDITION GRA VEL D ASPHALT D SIDEWALK D CURB D
TOP SOIL AREA)i:l SOIL TYPE C (", \.j
CUTS ASPHALT CUT _IT CURB CUT _IT SIDEWALK_IT
DRIVEWAY CUT _IT
MAIN CONDITION INTERNAL LINING W 6. TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSIO LOCALIZED D EXTENSIVE D
CHLORINE RESIDUAL SAMPLE - P.P,M.
WATEROFF FROM 0 fM. M. TO (; lD(JM.
FROM
M. TO
M.
APP ARENT CAUSE OF LEAK. 610 VV'! d Se ttl e