HomeMy WebLinkAbout214 Whidby Ave - Engineering
REQUEST
Date ~-~?--b D
CITY OF PORT ANGELES o'l~~\tP"~
DEPARTMENT OF PUBLIC WORK. S. . .O.vJ. ~. ~. /
. . . . . . . . . . . INSPECTION REPORT. . .
Time
Received by
(phone, person)
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Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected Date
Remarks
Time
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By
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RESTORATION REQUIRED
YES
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SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel D Asphalt D PCC
D Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
~MPLETE
D INCOMPLETE
D Other
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STREET SUPERINTENDENT
(DATE)
City of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No:
I b I?-
Reported: 5 1)..'J.t tJO
Repaired: 5 I p.J-t.. d:>
Repair Location:
Component Repaired:
Main.
Service:
Line Valve:
Hydrant:
Other:
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Jcrew:
7/V
Condition. Emergency Routine
Source: Citizen Complaint V
Leakage Survey _ Other
Address.
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Loc. Description.
f-
whl-Jby
Main Line ID#:
Joint eir Break
Long. Break_ Hole
Tap _ Corp Stop_
Flange Nuts, Bolts
Branch Valve
Split Bell _
Clamp _
Pipe-L
Stem
Barrel
Other
Curb Stop _
Bonnet
Dresser
Other f/..Il..}J-I!.W f /p.e a..-f S-df--e4-
Repair Type: Clamp _
Site Condition: Surface
Curb
Damage:
Cuts: Street Cut: Ft.
Main Condition:
Apparent Cause of Leak:
5/19/98
Gravel Roadway Asphalt Street _ Sidewalk
Top Soil Area ~ Soil Type _
Curb Cut: Ft.
Sidewalk Cut: Ft.
Diameter- Inches
Material.
Depth of Cover- Ft.
Internal Lining:
Tuberculation. NI A
External Corrosion: NI A
Special Conditions: Bedding:
Other Structures:
,-
Joint Type:
External Prot:
'.-,
Minor
Localized
Severe
Extensive
Samples Taken:
Pipe Section _
Water Off: From S- /~ dl>
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PW-902.09