HomeMy WebLinkAbout924 E 7th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST N
Date t-I~-O(
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 Plumbing
q~~ E 7~~
NK" \::~
Phone No
Permit No
Final Sewer Excav Other
~hY
INSPECTION NOTES
Inspected Date
Remarks
Time By
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RESTORATION REQUIRED
YES
/'
NO L/
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
D Repaired by City
[] Repaired by Permittee
o No Damage Found
WprkYrder #
[j--tOMPLETE
o INCOMPLETE
o Other
IJ~ 2.'8 - ()u '7
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
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~
CIty of Port Angeles
Public Works Department
Water DIstribution Repair Report
[Work Order No
]
DATE REPORTED
CONDITION
REPAIR LOCATION ADDRESS
DATE OF REPAIR, I-i ) - 0 Y TIME
Cf;A r
.
e -r- .L- SIZE
DAM. DP.M.
E- 71'/1
TYPE OF MAIN
~ '\
2-(
""
DEPTH OF MAIN
CLOSEST VALVE DEPTII,
CO!\.1PONENT REPAIRED. /
MAIN JOINT D CJR. BREAK ~PLIT BELL D LONG BREAK D
HOLE D CLA!\.1P D OTHER
SERVICE TAP D CORP STOP D PIPE D CURB STOP D FITTING D
METER SETTER D METER 0
LINE VALVE FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVED BARREL D
OTHER
CO!\.1PONENTS OF REPAIR. CL~SSERO OTHER
SITE CONDITION GRAVEL 0 ASPHAL T 0 SIDEWALK D CURB 0
TOP SOIL AREA~' SOIL TYPE
CUTS ASPHAL T CUT _IT CURB CUT _IT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE D
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SA!\.1PLE P.P.M. F- ('K-c'c/ .L-/I/-e
WATER OFF FROM
M.TO
M,
FROM
M. TO M.
5-e 17'I--e '0- c Jr-c:[ ~
APP ARENT CAUSE OF LEAK,