HomeMy WebLinkAbout610 Milwaukee Dr - Engineering
.....
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT . . . . . .
.....
REQUEST: ~
Date 6 - ?--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)
6/6 ~~)w.-((Jk-e-<-- /)VI
-rJ.o / I (oy
l'1fA If-8 Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other IJ.J ~y
INSPECTION NOTES
Inspected Date
Remarks
l//v--<-
Time By
~:;,:V'r~'ky- 6J.L/r_
"S-P r l/, /' +>
-
RESTORATION REQUIRED
YES
/'
NO~
IJ~
r
7D~ ~
111,( UJ. '{ ukfe-<- 1) Y I
C-
SURFACE RESTORA TIO
SURFACE TYPE
~
~
o Gravel
o Asphalt 0 PCC 0 Other
Work Order # ~S71
~PLETE
o INCOMPLETE
D Repair. d by City
[] Repa red by Permittee
[] No amage Found
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of l)ort Angeles
Public Works Departnlent t.f~ wp4f 5571-
Water Distribution Repair Report
IWork Order No.
DATE REPORTED
. S-577
6- ;) 5-0)
'Crew
7/ Y
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT(Q./
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR.
6- J- V -0 '} TIME
') l-r M DA.M. DP.M.
REPAIR LOCATION
TYPE OF MAIN
ADDRESS
$ (t' J1C-
SIZE.
DEPTH OF MAIN
CLOSEST VALVE DEPTH.
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL. 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE TAP D CORP STOP 0 PIPE ~URB STOP D FITTING 0
METER SETTER D METER 0
LINE VALVE FLANGE NUTS/BOLTS 0 STEM 0 BONNET 0
HYDRANT BRANCH D VAL VE 0 BARREL 0
OTIffiR.
COMPONENTS OF REPAIR. CLAMPO DRESSERO OTHER
.,t..- C CJ 1<1 r 5
f..- E jJl):?~ u (ouy;t ,nJ
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB D
TOP SOIL AREA cv10IL TYPE
CUTS ASPHALT CUT _IT CURB CUT _IT SIDEWALK_IT
DRIVEWAY CUT _IT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE
P.P.M.
! 6)4- M.
v+ ZhV'
/ h () 1))-€. 0
WATER OFF FROM
91TM. TO
FROM
M.TO
M.
{JJ,-/fIf-( f/-E- ~/P-rc
APPARENT CAUSE OF LEAK.
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date )-/) -05- Time 7; ,nJ .1fr\Received by 7/7 (Phone.S
location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
(,/i) ~/.v ?to/le-('
L-V6 T~/ ~t/
/7u'1 .S 13
Phone No. (/1]- l/'if'/<1
Sewer Foundation Framing Chimney Plumbing
Permit No.
Final Sewer Excav.~ ?r../a! e.r-
INSPECTION NOTES:
Inspected: Date <) -{?- - 0;;-
Remarks:
Time /1:uV A,~ By
7/7
f erl<',~ ,J.. .5e,/'VIc..c:., t?1a/~',- to 11,f~/</
RESTORATION REQUIRED . . . . .. YES V NO
c< 1
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.
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if. ',"
k:-- ~Js'io Ny!. Y..'. > I'
e
(YJ.I W ao//c<!c' Jr.
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SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved OGravel )2QAsPhalt OPCC OOther
o Repaired by City "Xo~k Order # 1 0 :) '16 - 0'-1 (
[] Repaired by Permittee -1J:COMPlETE At'e.o... ~~\~ vJ\'\'~
o No Damage Found , X INCOMPLETE ~\()~ ~ I y
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