HomeMy WebLinkAbout3129 Regent St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST
Date 9 ~ :) - 6 Lf
Time
Received by
(phone, person)
Sewer Foundation Framing
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(+II ~E Phone No
Permit No
Chimney Plumbing Final Sewer Excav Other 4 ) (~~ ~
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
INSPECTION NOTES
Inspected
Remarks
Date
Time
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YE~ NO
RESTORATION REQUIRED
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SUR ACE RESTORATION I ' /'
SURFACE TYPE 0 Unimproved 0 Gravel ~halt 0 PCC 0 Other
o Repaired by City Work Order # / c;) 7 ;?.... 0 Q 7
CJ Repaired by Permittee ~ COMPLETE t\t-e.L\ t~H'e.C.'X w\tY\
o No Damage Found 0 INCOMPLETE ~()'\ 1M, x: -:S-\h-(y-~
/-g' Q yeef fiYl) 0 I D4J=- - \ \<.
ICont;n e on ,eve..e side It necessa...,} STREET SUPERINTENDENT IDA TEl
CIty of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No
DATE REPORTED
! t;;2. 78-6 c:>if
~-28-6Y'
I Crew
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REP AIR LOCATION ADDRESS
CONDITION EMERGENCY D ROUTINE D CITIZEN COMPLAINT ~
LEAKAGE SURVEY D OTHER D
DATE OF REPAIR a - :A-C/-( - TIME
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DA.M. DP.M.
TYPE OF MAIN
SIZE.
.....
DEPTH OF MAIN
CLOSEST VALVE DEPTH.
COMPONENT REPAIRED.
MAIN JOINT D CIR. BREAK D SPLIT BELL D LONG BREAK D
HOLE D CLAMP D OTHER ,
SERVICE TAP D CORP STOP D PIP~URB STOP D FITTING D
METER SETTER D METER D
LINE VALVE FLANGE NUTS/BOL TS D STEM D BONNET D
HYDRANT BRANCH D VAL VE 0 BARREL D
OTHER.
COMPONENTS OF REPAIR. CLAMPO DRESSERO OTHER A7 -e /U-e c.u -Yy ;D-.E P/p,--e_
SITE CONDITION GRA VEL D ASPHAL T ~IDEW ALK D CURB D
TOP SOIL AREA D SOIL TYPE
CUTS ASPHAL T CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR D SEVERE D
EXTERNAL CORROSION LOCALIZED D EXTENSIVE D
CHLORINE RESIDUAL SAMPLE I '3 J P.P.M.
WATER OFF FROM g ,4- /tIl M. TO )0 It- M.
FROM
M.TO
M.
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APPARENT CAUSE OF LEAK.