HomeMy WebLinkAbout521 E 12th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS 12- q~
. . . . INSPECTION REPORT . . . . . . . . . . .
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REQUEST:
Date I Z -L 7-63
Phone No t..{-r 7 - tf 81.fCl
INSPECTION NOTES.
Inspected D te I Z- - L 7 -0 3
Remarks Z i~ C_~
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RESTORATION REQUIRED . . . .. YES 'X NO
SURFACE RESTORATION:
SURFACE TYPE D Unimproved D Gravel
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D Repaired by City
o Repaired by Permittee
o No Damage Found
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D Asphalt 0 PCC ~ Other Of/lie. t-U'::"'f
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Work Order # (L- Cj 01..= r
o COMPLETE
o INCOMPLETE
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STREET SUPERINTENDENT
CIty of Port Angeles
Public Works Department
Water Distribution Repair Report
'Work Order No
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ICrew- De.trlt<7 E i ReM, 13j T"Sdh IH
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DATE REPORTED (Z - Z- "7 - 6"3
CONDITION EMERGENCY ~ ROUTINE 0 CITIZEN Co.MPLAINT ~
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR. /7 - 2.7-03 TIME 1(' 30 l(A.M. OP.M.
52-I E- o z.. -ft...
REP AIR LOCATION ADDRESS ! -
TYPE OF MAIN C-I SIZE z...;( -
3f I r
DEPTH OF MAIN CLOSEST VALVE DEPTH. 22
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK)[ 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 NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTHER.
COMPONENTS OF REP AIR. CLAMP~ DRESSERO OTHER
SITE CONDITION GRA VEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE N4..-\i ve... ~. (o...y
CUTS ASPHALT CUT FT CURB CUT FT SIDEWALK FT
DRIVEWAY CUT <6 X 3 FT - -
MAIN CONDITION INTERNAL LINING Al/A TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION 'LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE AliA P.P.M. F(;(ed Uu.d.ev- rD"~(~LJe. fre~i.J~€-
WATER OFF FROM
M.TO
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FROM
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APPARENT CAUSE OF LEAK. 6 (ot/~ :5e f( (e
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS I 2- q ~
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date (z - z... 7 -63>
Time ,8 56 A.t.U\.. Received by JJ> ~(......,To~8person)
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Location of Work to be inspected 5' 2-1 E lZ-
Name of person requesting inspection j) EJ.,~+o. v-.......
Address of person requesting inspection urf) Kr'rd Phone No L{.I? - Cf8t.fCl
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Type of Inspection (circle appropriate one) Permit No -
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Othe@'- +e~
INSPECTION NOTES
Inspected ~te ~ Z- - L ~ ~o 3 ~
Remarks & .LIe:.., v L- C.,k
I
Time II 30
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(23~ob)
RESTORATION REQUIRED .
YES)(. NO
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt
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Work Order # ( L- (01..= ~, ,
~ COMPLETE ~\',~\ Q..~U~-
o INCOMPLETE \(e~\~d '-\-\b-a4
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STREET SUPERINTENDENT IDA TEl
D Repaired by City
o Repaired by Permittee
o No Damage Found