HomeMy WebLinkAbout2420 S Peabody St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . .
REQUEST _ t /d.. - ? D
Date 1 I 0 Time Received by
Location of Work to be inspected 1-. L{ AD 5,
Name of person requesting inspection -----=r: W ( \ ~
Address of person requesting inspection I '1. t/t '~B
Type of Inspection (circle appropriate one)
9uJ 'J-SI7-ll,Q3
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(phone, person)
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Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other 4.)c-t~
INSPECTION NOTES
Inspected Date
Remarks
Time
J!.~-UJ ~~ Wl~Y b'U/2--(
c u __b s -----57 ~ ~_~
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NO V
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RESTORATION REQUIRED
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1
/70 t
By
YES
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'Q
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()Jh IJ
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC / 0 Other
o Repaired by City Wor~rder # I 0 1 :3
[] Repaired by Permittee ~COMPLETE
o No Damage Found 0 INCOMPLETE
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(Continue on reverse side if necessary)
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STREET SUPERINTENDENT
(DATE)
City of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No. I &, r ;-
Reported. 1 / I / 17 1/
Repaired: 1 / l / P-?/
Condition.
Source.
Repair Location.
Address
Loc. Description.
Component Repaired:
Main.
DW 'Joo7 ~ (6~ S
ICrew: f( P'III, J' /7 5'P/''! , ;; cflC'1
, ,
Emergency V Routine
Citizen Complaint L---
Leakage Survey _ Other
7 'f ;)-v' rEA IS tl J1 t
. ., ,
'f- Y 4- 7 7 /v. OF 1/ AL-vE VIII AI /.IV c~/!A/e.K
(/ pre A Il V" P 'r Y W HI t? /> E r-
Main Line ID#:
Joint Cir Break
Long. Break_ Hole
Other
Service:
Line Valve:
Hydrant:
Other:
Split Bell _
Clamp _
Tap _ Corp Stop_
Flange Nuts, Bolts
Branch Valve
Pipe ~
Stem
Barrel
Curb Stop _
Bonnet
Repair Type: Clamp _
Site Condition: Surface
Curb
Damage:
Cuts: Street Cut: Ft.
Dresser
Other). l/Nlt'/V J cf:3 ~ I ,P E
Gravel Roadway _ Asphalt Street _ Sidewalk v'
Top Soil Area _ Soil Type _
Main Condition:
Diameter'
Material.
Depth of Cover'
Internal Lining:
Tuberculation.
External Corrosion:
Special Conditions:
Curb Cut: Ft.
Sidewalk Cut: Ft. 'f ~ c; r (;, 'x " 'f)' , K b I
- I I .
Inches /
f'~
Ft. '3 ~r I
"
T. ,
Joint Type.
External Prot:
N/A
N/A
Bedding:
Minor
Localized
G If /1/,/ e L
Severe
Extensive
Other Structures.
Samples Taken. Pipe Section _
Coupon _
Water Off: From q I 1 Ie (I To ll.f2!. rM
From q I 7 Iv v To ~./!.M
Apparent Cause of Leak: tI L t? f'..c
C~/lCK.ep
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5/19/98
Page 1
PW-902.09