HomeMy WebLinkAbout424 E 6th St - Engineering
CITY OF PORT ANGELES t>~-2-)ol -2.1S-3
DEPARTMENT OF PUBLIC WORKS 3D/I
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date b - ~ - () 1-
Time
Received by
(phone, person)
f 6f11
T ~0 II (.0;/
1..1J1L i) 0 Phone No
Location of Work to be inspected t{ iJ- <vi
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other (Ut~:f-er
INSPECTION NOTES
Inspected Date
Remarks
Time
CU+- IN Vi oF-
/~C,ZF ~~~~;~
By
Sell ~1? 6 f?u L LV /11t
-/-6 r-e,pC\ t y.. Lon J-
:l
r J\A~
RESTORATION REQUIRED
/
YES v NO
I /Jf J
~\ Vi)) Y
~ l l~~
1 >- l gq ,"7
~ ~ ~~
't b
,
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt
OPCC
OOther ~ >6 f L
:J / ~C:;- ?
D Repaired by City
D Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public \Vorks Departnlent tHu-,n;,I- 2.(S3
Water Distribution Repair Report
IWork Order No: ~ 153
ICrew>
Jll/
f
DATE REPORTED'
~- ?-.~rOJ-
CONDITION
EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT ~
LEAKAGE SURVEY 0 OTHER 0
I - ?-b-6 1-
f7 TIME.
j OtV}
L DA.M. DP.M.
ADDRESS L/ ;l ~ 1E- b fi\.
rr
f') (l C .-J---
tr\ SIZE.
DATE OF REPAIR.
REPAIR LOCATION
TYPE OF MAIN
""}t
DEPTHOFMAIN ~
CLOSEST VALVE DEPTH.
COMPONENT REPAIRED. / {.{' fu v~
MAIN JOINT 0 CIR. BREAK D SPLIT BELL. D LONG BREAK V frt'
HOLE D CLAMP D OTHER
SERVICE TAP D CORP STOP D PIPE D CURB STOP D FITTING 0
METER SETTER D METER D
LINE VALVE. FLANGE NUTSIBOL TS 0 STEM D BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTHER.
J. /' "L //( 0 c- filL PIP~
COMPONENTS OF REPAIR. CLAMPO DRESSER~ OTHER T 1 )
SITE CONDITION GRA VEL D ASPHALT 0 SIDEWALK D CURB 0
TOP SOIL AREA 'JZf SOIL TYPE
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT J
MAIN CONDITION INTERNAL LINING V-f... ~~'/ a TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE I 4 I P.P.M.
WATER OFF FROM I
f
M.TO
;2p M.
vt /11rt
1 JJo u ,;,t > 0
FROM
M.TO
M.
~, J UV~ -- -{hi 5 DNe.-
071t C\. ,71 /':JI"<c:A.. Jc J