HomeMy WebLinkAbout820 Milwaukee Dr - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . . . .
REQUEST
-')
Date -) - ;L"> -- lJ ?
Time
Received by
(phone, person)
Location of Work to be inspected ~ ~D 911 /7- v..H\. U k..-<~
Name of person requesting inspection ')- tA..J I ( (0 ~
Address of person requesting inspection I 1 flt -t/- 8
Type of Inspection (circle appropriate one)
j) r~1
Sewer Foundation Framing
Chimney Plumbing
Phone No
Permit No
Final Sewer Excav Other [J-/C(f-t'-y-
if
INSPECTION NOTES
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By
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YES V NO
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Inspected Date
Remarks
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RESTORATION REQUIRED
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SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel
D Repaired by City
[] Repaired by Permittee
D No Damage Found
~alt 0 PCC
Work Order #
~COMPLETE
D INCOMPLETE
~
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
LlLY OJ yon Angeles
Public 'Vorks Departnlent tiw- tf- '-{ 7-0 1---(
vVater DIstribution Repair Report
IWork Order No 41.0 7
I
ICrew
DATE REPORTED
S--Z3 LJ3
CONDITION ENlERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT 0
LEAKAGE SURVEY}iS. OTHER 0
DATE OF REPAIR. b -30 D3 TIME I! 30
REPAIR LOCATION ADDRESS 820 ;vt.dr..Jc,-J.Jkee-
U' (I'
TYPE OF MAIN 0 A -L SIZE.
DEPTII OF MAIN 3 -i f CLOSEST VALVE DEPTII. S
~A.M. DP.M.
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL. 0 LONG BREAK 0
HOLE 0 CLANW 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE)8( CURB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
OTIfER.
COMPONENTS OF REPAIR. CLANWO DRESSERO OTHER~' (ovp(rv\.cj":5 'f- :P E... I-..k':j
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHALT CUT (o><{() IT CURB cur _IT SIDEWALK_IT
DRIVEWAY cur _IT
MA1N CONDITION INTERNAL LINING fJA TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROS10N LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE 3 ~ ( P.P.M.
WATER OFF FROM (2 P M. TO (2 6(> M.
FROM
M.TO
M.
APPARENT CAUSE OF LEAK. C(iJ ajL -
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . INSPECTION REPORT. . . . . . .
REQUEST
Date S~ Z L/ r- C)r..(
Time ~ C; AWl... Received by Oe~'i:/5 C. (phone, person)
~
Location of Work to be inspected g'lo M; { w c....u ke ~
Name of person requesting inspection D.eV\ vi. l-S t:
Address of person requesting inspection Co rvJ YG..,.J..
f
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing final
D~
Phone No
Permit No ~
Sewer Excav Oth@o.... ~e r'"
INSPECTION NOTES
'Inspected Date ~ .- Z '-{ .- 04- Time (2- - 00 ;J M By Oe PI rt i '5 L
Remarks ketJc../r 3d; ;2e. se"-Vt~c.e.. (iVl-R-.
I
RESTORATION REQUIRED. .
. YES Y NO
I cg7-D ) J~,
1;--1
I
'3(~!,t- DeLp
0-
:
-~ 5' e 8'( A- c
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SURFACE RESTORATION
SURFACE TYPE D Unimproved 0 Gravel
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
I O~ 7 I
~ Asphalt 0 PCC D Other
Work Order # /t./ 278' - OsD
o COMPLETE
D INCOMPLETE
/nATFI
CIty of Port Angeles
Public Works Department
Water Distribution Repair Report
jWork Order No (i{Z 78 r 030
ICrew 7;5 "i--CyeuJ
DATE REPORTED S -2 Z --ot..f
CONDITION E:tvlERGENCY 0 ROUTINE 0 CITIZEN COtvlPLAINT ~
LEAKAGE SURVEY 0 OTHER 0
DATE OF REP AIR. ~- 2 t..( -otf
TIME 12 00
DA.M. ~.M.
Or
REPAIR LOCATION ADDRESS (fZ-o Iv(l( wCdJkee...
TYPE OF MAIN A-. C SIZE ?f Ir
DEPTII OF MAIN f-.( A- CLOSEST VALVE DEPTII.
~/A
.
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE b( CURB STOP 0 FITTING 0
:tvlETER SETTER 0 METER 0
LINE VALVE FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
OTIfER.
COMPONENTS OF REPAIR. CLAMPO DRESSERO OTHER 6W1..iJ. UvUOvt'S ~ C;" 0.(' 3ft{ Pt=.
I
SITE CONDITION GRA VEL 0 ASPHALT 0 SIDEW ALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHAL T CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING tJ/A TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION ( LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE P.P M,
('0 A
WATER OFF FROM M. TO
10 'I5AM.
FROM
M. TO
M.
APP'\RENT CAUSE OF LEAK,
1M.~ro0~r"'(I./ hedded tJ,IJ-e.
v / I , '(I
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date ,5 - Z 4 -- CJc.f Time ,':.;z~ c:; IItvt Received by Oe'1<US E.. (phone, person)
Location of Work to be inspected g w /lA; ( wc:zu ke e
Name of person requesting inspection U.et/\ V\:"" t;...
Address of person requesting inspection Cor-v? 'Ya....,f
I
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney Plumbing Final
Dr.
Phone No.
Permit No. ~
Sewer Excav. OthC0c...:-re r'
INSPECTION NOTES:
Inspected: Date 5 ~ Z'-( -- 0'-1 Time ('2..-: 00 f/k By 0<:''1 Y1. i ') E.
Remarks: /'?eiJarr 3/<; !2e.. S'e.--v'-c.e liv'l-L.
I
RESTORATION REQUIRED .. . . . .. YES Y. NO
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SURFACE RESTORATION: /01<.7'
SURFACE TYPE: 0 Unimproved DGravel ;glAsphalt OPCC o Other
Work Order # (l/Z73-o'S() 20<6\0 #:-1
jgJ COMPLETE 1-{o1 rplJ.lo.h () mil<"
0-1'{-Ol/
o No Damage Found 0 INCOMPLETE
~lfL~'f!ttYt sh U~ti""~.'N"Nn'N'
o Repaired by City
o Repaired by Permittee
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