HomeMy WebLinkAbout1927 W 6th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST
Date h-/}-oJ
Time
Received by
(phone, person)
Location of Work to be inspected t q :z 7 bU ~ -fit
Name of person requesting inspection T c.u t \ I ~ X
Address of person requesting inspection /7f4 cb-(} I Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other lAJO\:..+eJ,"-
INSPECTION NOTES
Inspected Date
Remarks
("70h
Time By
IJ ~ :> Jr' _$-e f., /,It'-C' -e L Ai-<--
9/l.f.!.<..t yt +0 C}lt(..f?Ht--- LJo --e -i-o ~c~ Ie
RESTORA TION REQUIRED YES NO
A'1\ .
. q ;2:1 (;-) ~ 1/'(
I . . fV i z.: -e
rF' / I;J ~!'~
c..vA:
" ~ ( ';?tI c..-
~. MJ .- ~?
~ t )' r~11 ~ ~
\)'
.'~ Lv 6+A \1'\
\'<1 ~
I
SURFACE RESTORATION <'
./
t/
SURFACE TYPE
D Unimproved D Gravel
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
D Asphalt D PCC
Work Order #
DOther ~p~ / L-
.
527)
D COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public 'Vorks Departnlent f{ti:- wF 5"? 13
'Vater Distribution Repair Report
IWork Order No: LJ~ 1 ? (Crew ~ / L(
DATE REPORTED 6 -I) -D ~ /
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT W
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR .t -1;-0 'j
TIME.
DA.M. OP.M.
DEPTH OF MAIN
/q'J--t
Rct Ire
, ( CLOSEST VALVE DEPTH.
w
6fh
REP AIR LOCATION ADDRESS
TYPE OF MAIN
SIZE.
COMPONENT REPAIRED.
MAIN JOINT D CIR. BREAK D SPLIT BELL. D LONG BREAK D
HOLE 0 CLAMP D OTHER --
SERVICE TAP 0 CORP STOP D PIPE ~URB STOP D FITTING 0
< METER SETTER 0 METER 0
LINE VALVE. FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH D VALVE 0 BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLAMPO DRESSERO OTHER Re;.; e 0
wa...4-eit/ ).f:?V(/ I C ~
.:fP'c"..i'l'l-/-6- .L.
SITE CONDITION GRAVEL 0 ASPHALT D SIDEWALK D CURB 0 ?11 ~'rc v
TOP SOIL AREA D SOIL TYPE
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEW ALK _FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED D EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE l ') 1 P.P.M.
WATER OFF FROM II 3D fM. TO :2.- /"jof
FROM M. TO
B r7ttt~ f- f PI P--L-
APPARENT CAUSE OF LEAK.