HomeMy WebLinkAbout3302 McDougal St - Engineering
CITY OF PORT ANGELES Dw-20ol--2{(8
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT . . . . . . . . . . . C4-c
REQUEST
Date 0'-1$- (5)-
Time
Received by
(phone, person)
Location of Work to be inspected :3 ~ -6 /- (.')111 C /)61/ f) ctL
Name of person requesting inspection }-U-J I) ~ -r
Address of person requesting inspection L-Jj1, i:r- J3 Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other LcJ :,~t--e) /'
INSPECTION NOTES
Inspected Date
Remarks
Time
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By
/AJ ?)/;\.Ll.-!-e" / (?'6Y
RESTORATION REQUIRED
//
YES V NO
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
~ther /Or ~v I 1-
:J./ I"?
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
(DATE)
STREET SUPERINTENDENT
CIty of Port Angeles
Public Works Departnlent bw. 2..C>Or . 21/ 8
'" ater Distribution Repair Report
IWork Order No.
. ~l{ ~
I Crew
r;/y
DATE REPORTED
l) -- I () -6 J-
CONDITION
EMERGENCY D ROUTINE D CITIZEN COMPLAINT m../
LEAKAGE SURVEY D OTHER D
/VI.
TIME 7' Jt-' DA.M. DP.M.
j:) () '- ~l ( tf()uC'}C( L
v
J-I~ b 2-
DATE OF REPAIR.
REPAIR LOCA TI0N
ADDRESS
TYPE OF MAIN
SIZE.
DEPTH OF MAIN
CLOSEST VALVE DEPTII.
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL. 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE TAP 0 CORP ST9~O PIPE 0 CURB STOP 0 FIITING 0
METER SETTER tY METER 0
LINE VALVE. FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLAMPO DRESSERO OTHER
SITE CONDITION GRA VEL 0 ASP~! 0 SIDEWALK 0 CURB 0
TOP SOIL AREA eY-"SOIL TYPE
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING TUBERCULA nON-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE ' J b P.P.M.
WATER OFF FROM
7ft
M.TO
.g Pr M.
/rcUS.e uu1-
/hV(
FROM
M.TO
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APPARENT CAUSE OF LEAK.
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