HomeMy WebLinkAbout1124 W 9th St - Engineering
CITY OF PORT ANGELES ll)tlti\
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date II -11- ~ 3
Time
Ie j'ry r/lCE R
o .' I t5' /l/17 Received by C/(/C - (phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
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Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected Date II - II - t/ .3 Time
Remarks ;;L"./11 A / /V 11 ,K E 4-):
f I - ;;>- #? 5' C H. ? C~
/ I 'f/t? 1'9/l? By
f'I/ 'I (//Y ?-
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RESTORATION REQUIRED
YES
NO ",..--
I 1'1 I
N
ft., 7 ~ y /XEe-:r ~
~ IE: - _~ 7S - - - / \\
-
/
X X- - ~ ). 17 ~ ..... 0
~ ~ ~
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
[] Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC
Work Order # W f",
~OMPLETE
o INCOMPLETE
o Other L,A- W)/
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(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
City of Port Angeles
Public Works Department
Water Distribution Repair Report
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'Work Order No' /VF, II J H'
, Crew K f)(V, <;;/- ~ S (//y
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J
DATE REPORTED If -1/ -?- 3
CONDITION EMERGENCY ~ROUTINE 0 CITIZEN COMPLAINT 0
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR.
11-11-0 J
II ?- Y-
TIME / () :' I ~ Q1(M. OP.M.
W7~
'J t',..
C~ SIZE r
/ /
CLOSEST VALVE DEPTH. ?- b 0
REPAIR LOCATION
ADDRESS
TYPE OF MAIN
}~
DEPTH OF MAIN )
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK 13"""'" SPLIT BELL 0 LONG BREAK 0
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 VAL VE 0 BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLAMPO DRESSERg"" OTHER
j" , f'lr€ 5CJ(:Jt rv
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE L,I} IV A/
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0.-- EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE #;) / P.P.M.
WATEROFF FROM Ip - IS" M. TO II tiP M.
FROM
M.TO
M.
APPARENT CAUSE OF LEAK. rfP/'E WAi eS'C/1I/;-:::'E P ~ ~;e
5'eJ1/E tJ? L-I/V E r (1?IN r F/L L. rtK. C A-~k
PH LI/V'€ '
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