HomeMy WebLinkAbout732 E 9th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . .
REQUEST
Date
Time
Received by
(phone, per.son)
~
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Location of Work to be inspected
Name of person requesting inspection i
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected Date
Remarks
Time
By
'~t
i
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RESTORATION REQUIRED
YES
NO X
Ir'
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order # I 7
{3 COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
City of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No .!-;
Icrew. -
I
Reported. -,::-/ ~/ t
Repaired. ~/ ~/_
Repair Location.
Component Repaired.
Main
Service:
Line Valve:
Hydrant:
Other'
Condition.
Source.
Address
Loc Description.
loint
Long. Break_
Tap_
Range Nuts, Bolts
Branch
Emergency Routine
Citizen Complaint y
Leakage Survey _ Other
. d
.,.
~ --c..v . 2-cJC>?- . 17-10
Main Line ID#:
r
Cir Break
Hole
Split Bell _
Clamp _
Other
Curb Stop _
Bonnet
Repair Type: Clamp
Site Condition: Surface
Curb
Damage:
Cuts: Street Cut: Ft.
Main Condition
Apparent Cause of Leak:
5/19/98
Corp Stop_
Pipe ~
Stem
Barrel
Valve
Dresser
Other ,., I
Gravel Roadway _ Asphalt Street _ Sidewalk Y
Top Soil Area ~ Soil Type ~,
. I. ( ~
) .
Curb Cut: Ft.
Sidewalk Cut: Ft.
DiaDleter' Inches
Material.
Depth of Cover' Ft. ...
Internal Lining:
Tuberculation:
External Corrosion.
Special Conditions.
Samples Taken:
Water Off:
~ ' {
I
,-
loint Type ;.\
External Prot.
N/A
N/A
Bedding:
Other Structures:
Minor
Localized
,.
Severe
Extensive
Pipe Section _
Coupon _
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PW-902.09