HomeMy WebLinkAbout828 W 13th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT. . . . . . . .
REQUEST
Date 0 S- -,!) 'D - 63
Time
1/ ;- .3 0 ~A- Received by l dr ~t C' 'f~
(phone, person)
Location of Work to be inspected B 2- B (:0. , ~-r--'~
Name of person requesting inspection W\ 0 c C) ><-.
\ 1--+1--~ I" ~ '
Address of person requesting inspection \ ~ Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other UJ :::-Jc,,-
7F '-/'7 10
INSPECTION NOTES
Inspected Date ()') - 26'-0.3
Remarks k~1) O.:.v.\ Q. d 2/1
^ ~)o-u, bc~
Time I ,.dO ;,J /1;--
.
e, w 0.... U/...J nltl.'vl/\
By
IIJ J +tl
t '~ ~A/\~
RESTORATION REQUIRED
YES
NO
'8' . !1J 'At s+
~+.
)
l~ o'-\- .
, .~ ,..
~ ~ \\ \ Q.fvl.
~ (
SURFACE RESTORATION NorJc li~ .'
SURFACE TYPE D Unimproved D Gravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other Lf 17 / [)
Work Order # L( -::;- { 0
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
LIty 01 IJort Angeles
Public 'V orks Departnlent
'" ater Distribution Repair Report
tt ~ -lA->P- {:l- I...( T 10
IWork Order No.
'1'7IU
.
ICrew 71'1
DATE REPORTED 05' - 2~- 03
CONDITION E!v1ERGENCY 0 ROUTINE 0 CITIZEN COIvIPLAINT 0
LEAKAGE SURVEY ~ OTHER 0
DATE OF REPAIR. OJ-~-03 TI!v1E 4~ Y!1/I1o-l'irA.M. OP.M.
REPAIR LOCATION ADDRESS S z- <g ...D /3--H)
TYPE OF MAIN
6.L.
~,
J CLOSEST VALVE DEPTII.
SIZE
2 (f
DEPTH OF MAIN
31
COIvIPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK i5 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 NUTSfBOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
OTHER.
COIvIPONENTS OF REP AIR. CLAMP~ DRESSERO OTHER
SITE CONDITION GRAVEL /l51. 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 1J I f+ TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE t 2.3 P.P.M.
WATER OFF FROM 1) rt M. TO q It M.
FROM
M.TO
M.
APPARENT CAUSE OF LEAK. ~ -+ ~U-.~