HomeMy WebLinkAbout818 Seamount Dr - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST
Date S- - f( t) '-f
Received by ~t.-\.IA..'S 6- (phone, person)
Ti me 7"",0 It- (tv-t
Location of Work to be inspected g (8 So
Name of person requesting inspection l)e V\. V\.. \ ".5
Address of person requesting inspection ~{J
I
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Othe~
INSPECTION NOTES
Inspected Date -S- - tl..() t
Remarks Kej}lA.,r ~/cf $e....-v
I
5~'^--t-
IS-
YO-rd (7"ik ~B
Phone No 't17-l/R'-f'l
Time 1(= t70 A ~ By f)~rtJ'11 5 E
( f' '^-L C c- 0 f fer) .
RESTORATION REQUIRED
818
Se-C...IM-<>'^ -+
YES X' NO
'S-
~
\~
\:;'C\
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SURFACE RESTORATION S-){ 7
SURFACE TYPE D Unimproved D Gravel )kf Asphalt D PCC D Other
[] Repaired by City Work Order # {'-(Z 7$ -()Z3- \C\ €S6- \
[] Repaired by Permittee ra:. COMPLETE ~~Q. t-~\ tee\ vJ\'\-lA
/ [] No Damage Found -/ D INCOMPLETE tlo" ~ \ 'l( 'S- \ C\ -0\
./fO SJf'c(/ei q;Z>~4ff \ K
(Continue on reverse side if necessary) STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No 1e-f1-18 -02."S
, Crew 7 (oS "'t- c...\J ei.J
DATE REPORTED
~ - -s--o--f
CONDITION ErvlERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT ;:(
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR. -5 --I ( ..-ot../
TIME
{I ~ 0 D ;ll(A.M. DP.M.
REPAIRLOCATION ADDRESS 8 (g .:5~ec....~vL +
TYPE OF MAIN 4- - L SIZE to (,
DEPTH OF MAIN .3 {. ( CLOSEST VALVE DEPTH. ~ z.1 (
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE ~ CURB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTIIER.
~
COMPONENTS OF REPAIR. CLAMPO DRESSERO OTHER ~ tv\..t1. U /If.. ( 0 ~
,
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHAL T CUT _FT CURB CUT _FT SIDEW ALK _FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING &-o-oJ TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE . ?Z P P.M.
WATER OFF FROM q S6 A M. TO cr 'Is AM.
FROM
M. TO
M.
APPARENT CAUSE OF LEAK. {)/A. kvt.D<.v V"\.....