HomeMy WebLinkAbout110 Vashon Ave - Engineering
City of Port Angeles
Public Works Departnlent
Water Distribution Repair Report
IWork Order No IZ~o~
I Crew 7 (5 - 71 7 - 7 Z 3
DATE REPORTED (2 ~ q -0;'
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT K.
LEAKAGE SURVEY 0 OTIIER 0
DATEo.FREPAIR. IZ-~ -O~
2-' 00 M".....
DA.M. p.r.M.
TIME
REPAIR Lo.CATIo.N ADDRESS /10 1)C\-5kO<A-
TYPE OF MAIN C- -L SIZE Zll
....
DEPTH OF MAIN
5"
CLo.SEST VALVE DEPTH.
3'
Co.MPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK Jl& SPLIT BELL 0 Lo.NG BREAK 0
Ho.LE 0 CL~ 0 o.TIIER
SERVICE TAP 0 Co.RP STo.P D PIPE D CURB STo.P D FITTING D
METER SETTER 0 METER 0
LINE VALVE FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE D BARREL D
o.THER.
Co.MPo.NENTS o.F REP AIR. CL~K DRESSERO OTIIER
SITE Co.NDITIo.N GRA VEL D ASPHALT 0 SIDEWALK 0 CURB D
To.P SOIL AREA 0 SOIL TYPE tJu.::fc t/e....
CUTS ASPHAL T CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITIo.N INTERNAL LINING NA TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL Co.RROSION LOCALIZED 0 EXTENSIVE 0
CHLo.RINE RESIDUAL S~LE NA- P.P.M.
WATERo.FF FRo.M 12- 3lJIM. TO. /' 30jJM.
FRo.M M. TO. M.
APP ARENT CAUSE o.F LEAK.
6y'2:)J~ se-tf Ie..
.....
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . INSPECTION REPORT. . . . . .
.....
REQUEST
Date / 2- - '1- 0 "5
Time
Received by [) Edj (~-fo"~e~oQL
Location of Work to be inspected I (0 t/~sLov\..
Name of person requesting inspection p. C~--i-3,--,,-
Address of person requesting inspection ~ p vyl ~J
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing Final
Phone No
Permit No ~
Sewer Excav Oth('!-cJ.-LT€ ('
INSPECTION NOTES
Inspected Date /'2- - c-1- O~
Remarks
Time Z /,/~
By D ~(~-hV'-
~
'--- J c:... '5 L-o ",,-- J
(\}
"-
~ I 1/6 l '0
"~ z" 'I' ,.-1 peel' \J
~ 0 . c]:. -:::, 0 . ~
'......
I ~
II D VA.Sko~
RESTORATION REQUIRED
YES V NO
o Repaired by City
[] Repaired by Permittee
D No Damage Found
o PCC 0 Other~ ,J~O'l (
/
Work.JXder # (2-4:0(..
IQ/COMPLETE \.-c~ -'
o INCOMPLETE D ~/Vf I J- - }'6 -0 ;
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)