HomeMy WebLinkAbout212 Whidby Ave - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
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REQUEST
Date ~'5' ,oc..f
.....
Time 'I: 00 P/vt Received by Vert fit ~'5 E- . (phone, person)
Location of Work to be inspected Z ( z- E t-Ukc'd b I' ,4 J L
Name of person requesting inspection .D~HJ..1.' ~ E
Address of person requesting inspection Lo-rIJ y'tt.rd I 7~ 't- '8 Phone No
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Type of Inspection (circle appropriate one) Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav OtheC;;6-+L?)
INSPECTION NOTES
Inspected Date (0 - 5' - oL/
Remarks M. e f)~ ( r h...o (.e... fIlL
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out ~ ~d re +tA/:) ~~I'V\..
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Time 7 00 PM. By D&trA.IS E-
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RESTORATION REQUIRED.
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~ tJkldby Ave
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SURFACE RESTORATION
SURFACE TYPE D Unimproved 0 Gravel
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
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YES X NO
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~ Asphalt D PCC D Other
Work Order # 1t.{3 fS--D03
o COMPLETE
D INCOMPLETE
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(Continue on reverse side if necessary)
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STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Department
Water DIstribution Repair Report
IWork Order No / t..{ 3tS- -- 003
I Crew 7 (~ "f- ere '<.J
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DATE REPORTED ~ - 5 -OY
Co.NDITION ENIERGENCY]2( Ro.UTINE 0 CITIZEN COMPLAINT }(
LEAKAGE SURVEY 0 GilIER 0
DATE o.F REPAIR. c,. ~- oc..(
TYPE o.FMAIN
TI1v1E 0 IS-
L-Jk~Jb~
8'r
SIZE
DA.M. ~P.M.
REPAIR Lo.CA TION ADDRESS Z. ( '-
A-c
DEPlli OF MAIN
Z'
CLo.SEST VALVE DEPTH.
f I
COMPONENT REPAIRED.
MAIN JOINT D CIR. BREAK D SPLIT BELL D LONG BREAK 0
HOLE){. CLAMP D OTHER Cor? -5+of (d,re.d -tAP) b l~vJ out o~ kA..a...:^
SERVICE. TAP D CORP STOP D PIPE D CURB STOP D FITTING 0
METER SETTER D METER D
LINE VALVE. FLANGE NUTS/BOL TS 0 STEM D BONNET 0
HYDRANT BRANCH 0 VAL VE D BARREL D
o.THER.
Co.rvtPONENTS o.F REP AIR. CLAMP)! DRESSERO OTHER
SITE CONDITION GRA VEL 0 ASPHALT b{ SIDEWALK D CURB D
TOP SOIL AREA D SOIL TYPE
CUTS ASPHAL T CUT 8 J<..IDFT CURB CUT _IT SIDEW ALK _IT
DRlVEW A Y CUT _IT
MAIN Co.NDITIo.N INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE D
EXTERNAL CORROSION Lo.CALIZED 0 EXTENSIVE 0
CHLo.RINE RESIDUAL SAMPLE tJ /It P P M.
WATER o.FF FRo.M L{..sofJ M. TO. (, 151 M.
FRo.M
M.To.
M.
APPARENTCAUSEo.FLEAK. ~riJ slot) b/~ "vi- 0+ ~~,
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