HomeMy WebLinkAbout208 E Orcas Ave - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
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REQUEST
Date I -- q - 03
Time
Received by j)~iS E. (phone, person)
"? .~, Q Of CdS Au e... .
Location of Work to be inspected C-U 0
Name of person requesting inspection ~kVL~ ., p. .
~~.J n~<4-B
Address of person requesting inspection /' ar-v- p
Type of Inspection (circle appropriate one)
Sewer Foundation Framing
Chimney Plumbing
Phone No
Permit No .' _. ---::::----
-- -..,
Sewer Excav Ot€ W~CJ
Final
INSPECTION NOTES
Inspected Date I - q - () S Time
Remarks l2e pcu'red 2 ({ C I ~lV'... hreA.. k
S/5 t-- ~ p~ t r- !oej_ <A...d .
By U-e<A-iA...' -s E
tA1~+l ~ --90(( C\r<...l~
RESTORATION REQUIRED
YES X
NO
~
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~ OYCACS Ave,
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t' 0\
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0- X- - --0 l./)
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208 --J...
O,rLA-S Ave...
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt
CJ Repaired by City
CJ Repaired by Permittee
CI No Damage Found
~ .
OPCC OOther 16v\S6 ( L
t'1 Q Q?, I
Work Order # ^- 0 L
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINT~NDENT
(DATE)
CIty of Port Angeles
Public Works Departnlent
'" ater Distribution Repair Report
IWork Order No.
2Z83
.
ICrew1 (5, 7tbJ 7 (2) 7/1
... ..
DATE REPORTED
(- 8- 03
TYPE OF MAIN
C.L.
3'
t'Jd
SIZE L
DEPTH OF MAIN
2 r G ~,
CLOSEST VALVE DEPTH.
COMPONENT REPAIRED:
MAIN JOINT 0 CIR. BREAK j)( SPLIT BELL. 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTIffiR
SERVICE. TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE. FLANGE NUTSIBOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLAMP)( DRESSERO OTHER
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHALT CUT _IT CURB CUT _IT SIDEWALK_IT
DRIVEWAY CUT _IT
MAIN CONDITION INTERNAL LINING tJA TUBERCULA TION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE *-.IP.M. F, )< eJ L. ~ e.
WATER OFF FROM M. TO M.
FROM
M.TO
M.
APPARENT CAUSE OF LEAK. "" yZlu..,A :5 e f{ I <t ~\