HomeMy WebLinkAbout116 Orcas Ave - Engineering
CITY OF PO'RT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date 10- 3b -0 J Time
[-e'l1)
Received by
(phone, person)
Location of Work to be inspected --1/ b
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
o r(,c.tA ,5 s-i I
T(D\~\ 6<,'1
I~. 4-- () Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other L;.Jt-t;\-ev
INSPECTION NOTES
Time 5 By
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fJ ~ ~ 0-' ~() II G~I-e (!?~ ·
Inspected Date
Remarks
. YES
/
/'
V NO
l'
!
RESTORATION REQUIRED
OR-- ~ut <;
~
1
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SURFACE RESTORATION
SURFACE TY~ 0 Unimproved 0 Gravel
/ 5 l,{~ - 0 Repaired by City
/1 V 1', (07 [] Repaired by Permittee
I' ,1 0 No Damage Found
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(Continue on reverse side if necessary)
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Asphalt 0 PCC 0 Other
W?rk Order # Ie 'l>l L, ·
g) COMPLETE ~~ ~-e{Y0..\ ~~
o INCOMPLETE Wtt\t\ .r~Q ~\~ >(
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STREET SUPERINTENDENT
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date /0 - '16 -0' Time
.
..
.
~
Received by
(phone, person)
Location of Work to be inspected II ~ 0 ~c.a.. ,5 s -l.. I
Name of person requesting inspection T (u \-\ l-1\ y:
Address of person requesting inspection ~ 4.--- () Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other --L).JA {-ev
Time t By
f!J ~.~ 1;; :~ ~:. ~) it J:- c~1-: ~~ ·
/'
/'
RESTORATION REQUIRED . .. YES V NO
INSPECTION NOTES
Inspected
Remarks
Date
[JR-- CA '>
~
~
\~
SURFACE RESTORATION
SURFACE TY~ 0 Unimproved 0 Gravel
/ C L-{~ - 0 Repaired by City
/1 V J 1', (07 D Repaired by Permittee
I' f 1 D No Damage Found
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o PCC 0 Other
Work Order # /6 ~I L
o COMPLETE
o INCOMPLETE
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City of Port Angeles
Public Works Department
Water Distribution Repair Report
'work Order No
DATE REPORTED
/6 c; 7 /
10 --- J (:) - D };
I Crew
/ / C/
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CONDITION ElvlERGENCY D ROUTINE D CITIZEN COMPLAINT J
LEAKAGE SURVEY D OTHER D
DATE OF REPAIR. /0-)6 - 6 ?TIrvIE
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II \0
DA.M. DP.M.
REP AIR LOCATION ADDRESS
6)~cC{5
5-+ [
TYPE OF MAIN
t'l r (
C'\
cr
SIZE.
/'It
DEPTH OF MAIN )
CLOSEST VALVE DEPTH.
/'
COMPONENT REPAIRED. /
MAIN JOINT D CIR. BREAK .tV'" SPLIT BELL D LONG BREAK D
HOLE D CLAMP D OTHER
SERVICE TAP 0 CORP STOP D PIPE 0 CURB STOP 0 FITTING 0
rvIETER SETTER 0 rv1ETER D
LINE VALVE FLANGE NUTS/BOL TS D STEM 0 BONNET D
HYDRANT BRANCH D VAL VE D BARREL D
OTHER.
COMPONENTS OF REPAIR CLLsSERD OTHER
SITE CONDITION GRAVEL D ASPHALT D SIDEWALK D CURB D
TOP SOIL AREA ~ SOIL TYPE
CUTS ASPHALT CUT _FT CuRi3CUT _FT SIDEWALK_FT
DRlVEW A Y CUT _FT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR D SEVERE D
EXTERNAL CORROSION LOCALIZED D EXTENSIVE D
CHLORlNE RESIDUAL SAMPLE
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P.P.M.
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WATER OFF FROM
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FROM
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APP ARENT CAUSE OF LEAK.