HomeMy WebLinkAbout707 E 10th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date ~... t f::. - 6 I
Time
Received by
(phone, person)
Location of Work to be inspected /0 1 k /6 fit
Name of person requesting inspection -r W t r Co y
Address of person requesting inspection /1 A +~ Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other L,.Jt\. f-t'//
INSPECTION NOTES
Inspected Date
Remarks
Time Br
4fpti.-t ;I:' :!'t/v< '~J^- ~y
~i l ~ If C(r-cl-t> !3ott1tf-
*N\A
RESTORATION REQUIRED
YES
/'
NO L/
.'{.., f( --R(JACr AJ1'
~ / ~
Q,- 4- II'- ~'< ,AJv ./ e '-\
L~ ~ 53(~ \.
V
~ /6-M 5-J- \'
~ ~
if
I
SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
D Asphalt D PCC
Wor~rder #
rp/COMPLETE
D INCOMPLETE
D Other
iJ- -;1
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
City 01 IJort Angeles
Public ';Yorks Departnlent ~-~ '{'2. T r
vVater Distribution Repair Report
IWork Order No
DA TE REPORTED
L/J- (1
I I
)--/6- D;;
I Crew
7/~
, I
REP AlR LOCA nON
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT ~
LEAKAGE SURVEY 0 OTHER 0
DATEOFREPAlR. L)-/(-6! TIME. /(J6
707 k-
J.. (I 6Y:t 11/ SIZE
DEPTII OF MAIN ~ ~ CLOSEST VALVE DEPTII.
ADDRESS
~.M. OP.M.
I
/6r~
TYPE OF MAIN
COMPONENT REPAIRED.
MAIN JOINT O. CIR. BREAK 0 SPLIT BELL 0 LOg BRE. AK J! J
HOLE!( CLAMP 0 OTHER /:- ' d-E'
SERVlCE TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE. FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
OTI-IER.
COMPONENTS OF REPAIR. CLAMPO DRESSERO OTHER
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP Son.. AREA 0 SOn.. TYPE
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING 1lJBERCULA TION-MINOR 0 SEVERE 0
EXTERNAL CORROS10N LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE ~P.P.M.
M. ;<-ep",-('yO! t/V-C
WATER OFF FROM
M.TO
FROM M. TO M.
~PARENTCAUSfOFLl'AK ~-e r-t: It'u ~tV V...e Vi1 . 120 ~M (,
httiJ< /1lt;d N-e,Oo../ ~ C) _ l-f/J /' S . < /~ c-k. ~ 1tf<-PtZt: Y
SA. v I ci lr ~f I{l ( -e - I~ 0 Ik .1-0 )11 +dn -e =-J-o
fl u > ) I /<(....e cI [U~ +e r c. /-e tZ /r- --