HomeMy WebLinkAbout910 W 16th St - Engineering
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CITY OF PORT ANGELES
DEPARTMEN'T OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . .
I C I 1-' I
REQUEST
Date 5" - /(P ~ 0 I
Time (0 SoAW\. Received by Vt-'ddS E (phone, person)
Location of Work to be inspected C} 10 tJ t C. 1}.
Name of person requesting inspection Veu.-41.( ~ E:-
Address of person requesting inspection 17 ~ '+ /3 CC/Y'p ~t'J Phone No '-It 7- 'IRt./9
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other ~t.fetr-
INSPECTION NOTES
Inspected Date 5 -( c,;' 0 (
Remarks ;(elJ~l-'-- 3/,,;( PE
I
Time
Serv'tc.e....
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By
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A~p'lA.1 f CUT
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RESTORATION REQUIRED
YES X
NO
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/ C, lit ?:! I
I
2'1 CI 14' 120' ~ t \
,.... ~
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910 W 16~
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
Cl Repaired by Permittee
CI No Damage Found
14, s C;<j~J.~J+ <-vf M:s
--. I ,- S+r-eEVf-
,
(Continue on reverse side if necessary)
~'Asphalt 0 PCC
Work Order # /85/
~ COMPLETE -6- 2Li-O\
o INCOMPLETE ,\L..
rt (,M. C )
o Other
a ~~~' e;te-L Oh.
5//. 0 / ::=
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Department
Water Distribution Repair Report
~U-' -;z.oo1-1!;S- I
IWork Order No: I if"?- f
ICrew. ?Zeo
721./ ~ 7Z.C,
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DATE REPORTED' 5--/5 -{..; I
CONDITION EMERGENCY D ROUTINE D CITIZEN COMPLAINT ~
LEAKAGE SURVEY D OTIffiR D
DATE OF REPAIR. ~ -/5' -0 I TIME. ~ L( 3D DA.M. t&>.M.
q I t /(~
REPAIR LOCATION ADDRESS 10 {t./ (,;:>
TYPE OF MAIN
~t -
~ C.'/'"
z.."
SIZE.
DEPTH OF MAIN Z -4 I
'? t
CLOSEST VALVE DEPTH. ~
COMPONENT REPAIRED:
MAIN JOINT 0 CIR. BREAK D SPLIT BELL- 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTIffiR
SERVlCE. TAP 0 CORP STOP 0 PIPE):( CURB STOP 0 FITTING 0
METER SETTER D METER 0
LINE VALVE. FLANGE NUTSIBOLTS 0 STEM 0 BONNET 0
HYDRANf BRANCH D VALVE D BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLAMPD DRESSERD OTIIER f?.e f,t'e. L.,.......~ Jl'1.l0~ .5-rAII-1.I~<7 ~t.l.se~
1'/" "
SITE CONDITION GRAVEL 0 ASPHALT ~ SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE hc....f I ve.
CUTS. ASPHALT CUT ~FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION. INTERNAL LINING AJ. It TUBERCULATION-MINOR D SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE D
C:m..ORINE RESIDUAL SAMPLE .. 75'" P.P.M.
WATEROFF FROM 55l> PM. TO 6" i> M.
FROM
M.TO
M.
APPARENT CAUSE OF LEAK. gr--Dv'~J 5et-f~1~