HomeMy WebLinkAbout710 Milwaukee Dr - Engineering
o '.u - 2. 00 ':} - /8'2- 8
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . INSPECTION REPORT. . . . . .
qD3
REQUEST
Date l / ~ / ('0 - ( (
,
Time
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)
!y)v, I ~ L L {/( (J j", -P ..--.'"
1)'/1
+ D
Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other {I<~! {1 1-t1/
INSPECTION NOTES
Inspected Date [)- I t, .~ c
y
Remarks
By
I r~.
i, "'-)!. I
6/
-; y
7"
It
" -r'
'-
:::
1.:' /
<1~~/'\_ if >"
RESTORATION REQUIRED
YES
NO ,~---
1=7~1{
-----1-------.-------- .-
,,J\ -""\
1 tj~ ll'u, \
() I.,j
U it. \ ~ .
)-- - ~~1' \/.e -;;~ ..' f. 'r [-1-0 i '1 'l~ I';,,{{;/; ~ fCO('l"t f<Y
- 1 I /') 1'1:(: t;Jf(J " ;. / '\ / ;).-. -~
J C </fJ I I f\1.{':~' I A P f;- r-~o r"l -~hF'-<(' i
v il'~ // _____ f.:', ~ L-.- "',;, t\ j I . ,
~ 1 ~..; l) t) r 1.'
-;1 ( i J ,,- ~, t, r (" <- J
-'
, t ,.('
Of/! I / 1,-,,1 u;.~
Pi- ,
'~
"
\-\
~
~n____ ~____
1 Cu\,\,O'" \
~'- )
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 pcc
o Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
~OMPLETE
o INCOMPLETE
o Other
/70.15::
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
~"""" - '2,...001- Ie).. 8
CIty of Ilort Angeles
Public '" orks Departnlent
Water Distribution Repair Report
CONDITION
l. t' /1
..- 1;)-
EMERGENCY D ROUTINE D CITIZEN COMPLAINT ~
LEAKAGE SURVEY D OTIffiR D
I ICrewo II ~(
r: ) (
IWork Order No:
) ., 'j 'd
,~ ;---- E"
p
DATE REPORTED'
DATE OF REPAIR. 11- /6 't', \ TIME.
REPAIR LOCATION ADDRESS 1/ D
I
DA.M. DP.M.
~~ I k' /?
/I iI, 1 L (1_ f' _t' 1'~
[) J/ ,
TYPE OF MAIN
1; t !t-("-
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 OTIffiR
SERVICE TAP 0 CORP STOP D PIPE~' CURB STOP D FITTING D
METER SETTER D METER D
LINE VALVE. FLANGE NUTS/BOL TS 0 STEM D BONNET D
HYDRANT BRANCH D VALVE D BARREL D
OTHER.
COMPONENTS OF REPAIR CLAMPD DRESSERD OTIffiR
< ~I ;
.-/--r. L' , ( ~...--
,.
/J ///-, ~
.IF" ;:f-' ,-><
;>>
SITE CONDITION GRA VEL D ASPHALT D SIDEWALK D CURB D
TOP SOIL AREA ~ SOIL TYPE
CUTS ASPHALTCUT_Ff CURB CUT _Ff SIDEWALK_Ff
DRIVEWAY CUT _Ff
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR D SEVERE D
EXTERNAL CORROSION LOCALIZED D EXTENSIVE D
CHLORINE RESIDUAL SAMPLE I 3 f P.P.M.
WATER OFF
FROM q.b If:- - 1 M. TO
, JfM.
/- h /.(fJ ;; < 6- (if
I (.
.rl r. j~ ,
.;7'" ! I.'
,- . "I t ? //
i'l t- r. u -
FROM
M.TO
M,
APPARENT CAUSE OF LEAK.
o
~ /1'
-~ "f-- rK /{ j