HomeMy WebLinkAbout2024 W 15th St - Engineering
CITY OF PORT ANGELES /fIe wf- 77~'
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST. D "2.
Date q~ I D-- I Time Received by (phone, person)
.n 0 :l- tf F;;J (z:~t41
Location of Work to be inspected C?\ 1 u..::I j I~.
Name of person requesting inspection '--"Lv l ' I Uv Y
Address of person requesting inspection I 1 {1{ 6- 0 Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other j JJ c ('j-( V-
INSPECTION NOTES
Inspected Date
Remarks
Time By
R € IU--e I..c.) U w c;t;;J-- J-e rur ~
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R~ STORA TION REQUIRED YES NO
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CY ~
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SURFACE RES'" ORATION
SURFACE TYPE 0 Unimproved 0 Gravel
[] Repaired by City
[] Repaired by Permittee
[] No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # II V h
cB-cOMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
Llty 01 IJort Angeles ;-ITE f/.JP- 77c.ft
Public 'Vorks Departnlent
'" ater Distribution Repair Report
IWork Order No.
CONDITION
]'7 (/ Co
1;-/6--0'7
EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAlNT /'
LEAKAGE SURVEY 0 OTHER 0
o -/o-@ 7 TIME. I Ar 52> DA.M. DP~
ROAC( W 1)~11
I Crew
7/Y
DATE REPORTED
DATE OF REPAIR.
REP AIR LOCATION
ADDRESS
TYPE OF MAIN
9- r(C -1--
SIZE
DEPTII OF MAIN
CLOSEST VALVE DEPTH.
COMPONENT REPAIRED:
MAIN JOINT D CIR. BREAK D SPLIT BELL D LONG BREAK D
HOLE 0 CLAMP D OTHER /
SERVlCE TAP D CORP STOP D PIP~CURB STOP D FITTING D
METER SETTER 0 METER 0
LINE VALVE. FLANGE NUTS/BOL TS 0 STEM 0 BONNET D
HYDRANT BRANCH D VALVED BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLAMPO DRESSERO OTHER
SITE CONDITION GRA VEL 0 ASPHALT 0 SIDEW ALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_IT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED D EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE I 2 7 P.P.M.
WATER OFF FROM ) 2:'3D fM. TO ;). P M.
L- 6~ jRVl/l?-z.
o J'I
;hDUS..e
FROM M. TO
M.
DJJ i/y CofJ~V Ro1fi;-/CJu-f
APP ARENT CAUSE OF LEAK.