HomeMy WebLinkAbout1628 W 8th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
/
/
REQUEST
Date !J.. - ,,)...- 00
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)
It?-~ 10 )?~
T 00"' I (oX
It f11 ~ t3 Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other {Al ~y-
INSPECTION NOTES
Inspected Date
Remarks
L-o I '1h
Time By
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~ 1 ;t1 I ~c CY"Y
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RESTORATION REQUIRED
~
.. YES L.,/ NO
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt
OPCC
o Other '7TY? 56 I L
,
1)):2-
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
City of Port Angeles Ok);i 501 -I s--S-^
Public Works Department
Water Distribution Repair Report
IWork Order No: is- S-?-
'crew: (I Y
Reported: ~/:2./ 100
Repaired: ds....J ~J 0 (}
Condition.
Source.
Emergency
Citizen Complaint
Leakage Survey _
~
I
Other
Repair Location:
Address
16 ~'<6
,
w
1-t'1
Loc Description.
Component Repaired:
Main Line IDU"
Main:
Joint
Long. Break_
Cir Break
Hole
v
Split Bell _
Clamp _
Other
Service: Tap _ Corp Stop_
Line Valve: Flange Nuts, Bolts
Hydrant: Branch Valve
Other:
Pi
pe-
Stem
Barrel
Curb Stop _
Bonnet
Clamp /"
Dresser
Repair Type:
Other
Site Condition: Surface
Curb
Damage:
Gravel Roadway _ Asphalt Street _ Sidewalk
Top Soil Area _ Soil Type _
Cuts: Street Cut: Ft.
Curb Cut: Ft.
Sidewalk Cut: Ft.
Main Condition:
Diameter' Inches
Material.
Depth of Cover' Ft.
Internal Lining:
~.. ( C-J--
,.
Joint Type:
External Prot:
Tuberculation. Nt A
External Corrosion: Nt A
Special Conditions. Bedding:
Other Structures:
Minor
Localized
Severe
Extensive
Samples Taken. Pipe Section _ Coupon --.116 1IJ .R.-
Water Off: From ~ t J..'2t 0 D To ~
From 2::=..1 2:2:f 6 b To ~ M
s~tf-I-<-
<:fr
C tra. c k
Apparent Cause of Leak:
5/19/98
Page 1
PW-902.09