HomeMy WebLinkAbout228 W 7th St - Engineering
REQUEST
Date J - Ab -~ L(
,
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
Time
Received by
(phone, person)
Location of Work to be inspected 2. A. 'is w
Name of person requesting inspection -y-;- "0 j / (A ~
Address of person requesting inspection 11 f11 ir t3 Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other ~
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INSPECTION NOTES
Inspected Date
Remarks
Time By ~
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RESTORATION REQUIRED
/'
YES i./' NO
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SURFACE RESTORATION
SURFACETYPE 0 Unimproved OGravel o Asphalt OPCC OOther '"7;JP5o ) 1-
o Repaired by City Work Order # ) 3??;Z "2
CJ Repaired by Permittee 0 COMPLETE
CI No Damage Found 0 INCOMPLETE
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(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No~ <i?2 <;? - / D 1
1-- J-~-6//
[Crew
'71 L/
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]
DA TE REPORTED
CONDITION E.MERGENCY D ROUTINE D CITIZEN COMPLAINT ~
LEAKAGE SURVEY D OTHER D
DATE OF REPAlR. TIME
REP AlR LOCATION ADDRESS ::L ?- ~
.r) tf +
TYPE OF MAIN .:Z::::: C - _ SIZE
DA.M. DP.M.
W 7~A
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DEPTH OF MAIN
CLOSEST VAL VE DEPTH.
,./'
COMPONENT REPAIRED. . /'
MAIN JOINT 0 Crn.. BREAK V SPLIT BELL 0 LONG BREAK D
HOLE 0 CLAMP 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE FLANGE NUTSIBOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVED BARREL 0
OTHER.
/
COMPONENTS OF REPAIR. CL~RESSERO OTHER
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHAL T CUT _IT CURB CUT _IT SIDEWALK_IT
DRIVEWAY CUT _IT
MAIN CONDITION INTERNAL LINING TUBERCULA TION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE P.P M. Jr-ePct./;</ 1--1 'y-E:.-.
WATER OFF FROM M. TO M.
FROM
M.TO M. J
FY<))40, ~~~~~YJun
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/31(1
APP.A.RENT CAUSE OR-EAK.
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