HomeMy WebLinkAbout510 W 16th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . .
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REQUEST
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Date -<5 -
Time 1-: u U tlt/L1 Received by ~o y Ir..:- 1-'1 (phone, ~rgm)
Location of Work to be inspected ~~ I 0 uJ ~ --s + I 0 tfJ:-- -+-f-~k -.::- {
Name of person requesting inspection 75 2>.c-u~I'+o,/'d
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Address of person requesting inspection i"7 - t l::, (roll p F A-,e/) .
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav
Phone No
Permit No
Other
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INSPECTION NOTES
Inspected Date ( - .) -- 0 ()
Remarks ,:J. II (--;1..I u) ll4--k-t{.
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Time /0 DU A---t-Vj By 6 ~~tle;-~ldK~
M A. u L ~ 74- t -- (2 t= -j) ute eeL IN I -fi1. t':::r.E
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RESTORATION REQUIRED
YES V' NO
SURFACE RESTORATION.
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City Work Order # IS- L t--
Cl Repaired by Permittee 0 COMPLETE
o No qamage Found 0 INCOMPLETE
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STREET SUPERINTENDENT
(DATE)
City of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No: 1St '1
Reported: _,_,_
Repaired: c ( , 057 00
Condition:
Source:
R~air Location:
Address:
Loc. Description:
Component Repaired:
Icrew: Bnl B. /r#Xlyr- I (JO~- s~1
Emergency Routine
Citizen Complaint
Leakage Survey _ Other
S'ID CUt S+ /0 r.e ..$. ~~C-{
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Main Line ID#:
Main: Joint eir Break
Long. Break _ Hole v'
Split Bell _
Clamp _
Other
Service: Tap _ Corp. Stop _
Line Valve: Flange Nuts, Bolts
Hydrant: Branch Valve
Other:
Pipe _
Stem
Barrel
Curb Stop _
Bonnet
Repair Type: Clamp V
Other
)
Site Condition: Surface
Curb
~ Damage:
Dresser
Gravel Roadway _ Asphalt Street _
Top Soil Area ~ Soil Type _
Sidewalk
Cuts: Street Cut: Ft.
Sidewalk Cut: Ft.
Tuberculation: NI A
External Corrosion. NI A
Special Conditions: Bedding:
Other Structures:
Main Condition:
Diameter-
Material.
Depth of Cover.
Internal Lining:
Curb Cut: Ft.
I'
Inches 7-
I..". , .:c '
Ft. .L{ (
l'
tr,<c
Joint Type:
External Prot:
Minor
Localized
Severe
Extensive
Samples Taken: Pipe Section _
Coupon _
Water Off: From 1 I To _M
---
From 1 1 To M
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Apparent Cause of Leak: p,'1J II\.{)L~ (=I4-fr... t A.J b~:E. "2-- t I t....J t~7e tt 1 r1-r A.J
5/19/98
Page 1
PW-902.09