HomeMy WebLinkAbout218/222 Lopez Ave - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . .
REQUEST
Date 1-10--03
Time ,~f)/VI..
I
Received by VeIL/lIS E (phone, person)
Location of Work to be inspected 3cft(./~ ~ vL ? 1'6 -;- 2 Z. -L L .:> ~e Z. Au e..
I
Name of person requesting inspection Vi! I-i Vi.-I S C
Address of person requesting inspection 17 ~ "f- '6 ~./J '/~rJ Phone No
I
Type of Inspection (circle appropriate one) Permit No-~
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Oth@L.+0
INSPECTION NOTES
Inspected Date I - i 0 -(.) ~3
~ - II /~
Remarks r::,-fL(J cA. I r. z.. L-1..
re r6--t r bCLVu:!..
Time 5" /)Ivt ByUenlt.,<5 E
t-IA..-o-t-v\. bre-c..j( ,(./J<-+-~ tZ... S/~ ~uif ClrClL
.
RESTORATION REQUIRED
YES ~-
NO
~ D
J.-.
v') l
~ L-ope 2- A vie V)
~ ,~
~ ~
"- k \J
" ,;7 72 ~ 2'1 C.L 3-' " /k4>
0 -f)
2/8 2Zz.
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt
OPCC
~Othero/~( I
2ZflS-
o Repaired by City
Cl Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Departnlent
'" ater Distribution Repair Report
'Work Order No. '2~ 8s-
'Crew 7(~ - 717. - 7$
DATE REPORTED I ~ ID ():>
CONDITION EMERGENCY D ROUTINE D CITIZEN COMPLAINT ~
LEAKAGE SURVEY D OTHER D
DATE OF REPAIR. I ~iO ()~ TIME ~ DA.M. J2(p.M.
REPAIR LOCATION ADDRESS BertJ e.e.vL L ; "6 'if ZZL L~{JQ...,.<- Ave
I
TYPE OF MAIN LX SIZE 2-('
DEPTH OF MAIN 3IC/' CLOSEST VALVE DEPTH. '-If
COMPONENT REPAIRED:
MAIN JOINT D CIR. BREAK)( SPLIT BELL. 0 LONG BREAK 0
HOLE D CLAMP 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FIITING 0
METER SE1TER 0 METER D
LINE VALVE FLANGE NUTS/BOLTS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
OTIffiR.
COMPONENTS OF REPAIR. CLAMPji( DRESSERO OTHER
SITE CONDITION GRA VEL D ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA JI( SOIL TYPE MoL f-, J <-
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT FT
MAIN CONDITION INTERNAL LINING AI A TUBERCULA TION-MINOR D SEVERE 0
EXTERNAL CORROS10N I LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMP~E ^fIA P.P.M. (P>)l e J t I ./ ~_ )
WATER OFF FROM IIfA M. TO M.
FROM M. TO M.
APPARENT CAUSE OF LEAK. 6~u.-J ~ff!~