HomeMy WebLinkAbout2407 1/2 S Peabody St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date }). - J 1--01 Time
I
Received by
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing
;'il; ,Y:; ;:
l )1 r y
7 (ll ~ 0 Phone No
if.e 4../aoj ~/
(
Permit No
Final Sewer Excav Other LJJt{ ~
INSPECTION NOTES
Inspected Date
Remarks
Time By
lif!-f/~t; r (';" C - L &U~
(' !N'{f J1/ ( AJ if), (2r J I c { rc 1-<: &~,
RESTORATION REQUIRED
YES
./'/
N~
Nf
~
\j
~
'tr
~
'?Jb (
r
~
!-. D p-e 2-
SURFACE RESTORATION
SURFACE YPE D Unimproved D Gravel
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
D Asphalt D PCC D Other
Wor~rder # I ~ ~. ~ 7
~COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Departnlent
Water Distribution Repair Report
IWork Order No
CONDITION
/u ~( ICrew 71 y
I?--( -;--0 J
~MERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT ~;
LEAKAGE SURVEY 0 OTHER 0
DATE REPORTED
DATE OF REPAIR.
/2 -( /-01
TIME
DA.M. DP.M.
Yz- 5, j?-("?~hoclv
t ,
REP AIR LOCATION
ADDRESS
2Cfc 7
9-.: ( c ~ SIZE
.1'
,_ CLOSEST VALVE DEPTH.
TYPE OF MAIN
DEPTH OF MAIN
COMPONENT REPAIRED. . /'
MAIN JOINT 0 CIR. BREAK~ SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE TAP 0 CORP STOP D PIPE 0 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
OTHER.
COMPONENTS OF REP AIR. CL~~SSERD OTHER
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE P.P.M.
WATEROFF FROM :2fM. M. TO )p~.
f--e(kV",--<J U)V d..fJ 't-
(/0 S 5,' f( /J ~ ?y-e .5 5"vv <-
FROM
M.TO
M.
APP ARENT CAUSE OF LEAK.
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