HomeMy WebLinkAbout214 E Lauridsen Blvd - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT . . . . . .
.....
REQUEST
Date 5-22 ~- o~
Time
Received by
Location of Work to be inspected 2 (4
Name of person requesting inspection ..v,
Address of person requesting inspection
Type of Inspection (circle appropriate one)
E Lv,vl-IJ~C k
E dJ l ~to-v..
DLV-2007Z-- 2 (2-j-
.....
5fD
(phone, person)
Phone No
Permit No
n
Sewer Excav Other pL/C/__T ~ ,.-
Sewer Foundation Framing
Chimney Plumbing Final
INSPECTION NOTES
5- Z 2.-0'-
Inspected Date
Remarks K~ th_1 r'"
I -
ItA... e -t e t---
Time By
I" L.o~er :5e,r-\!; C.c_ (er.\.k ~ '001...... LVII' 1-D 2; +"..~k..n::Js
e ~. ;~- c," ,Or C':>''l...c::... StC'wer ItVLe. brokelr\... d ..;rloA.' e)(<:e\'v'...t~.
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
f5Vork Order No
\..-.llj VI rUIl A11gele~
Public Works Department ))w-::<OO1--Z12S-
Water Distribution Repair Report
Z I zs-
.
]
[<:rew 71'5", 7/"', 717, 718
J
DA TE REPORTED ~ 5" -2tl -- 0 '2
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT )f
LEAKAGE SURVEy 0 OTIIER 0
DATE OF REF AIR 5-- Z Z - 0 ;: TIME 2 '/5 DA.M. ~P.M.
REPAIR LOCATI0N ADDRESS Z(~ E. ~ v,"'- tel ~e,,\ 5( vd
/J -C~ 8',r
TYPE OF MAIN rt SIZE.
,.f I .?(
DEPTH OF MAIN...., CLOSEST VALVE DEPTH. ...:>
COMPONENT REPAIRED:
MA1N JOINT 0 C1R BREAK 0 SPLIT BELL. 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTIIER
SERVlCE TAP 0 CORP STOP 0 PlPE /J( CURB STOP 0 F11TING 0
METER SETTER 0 METER 0
LINE VALVE. Fl.ANGE NUTSfBOLTS 0 STEM 0 BONNET 0
HYDRANr BRANCH 0 VAL VE 0 BARREL 0
OTI1ER.
COMPONENTs OF REF A1R CLAMPD DRESSERD OTHER f! E 'Tv",~
SITE CONDITION GRAVEL~' ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOn.. AREA 0 SOn.. TYPE
CUTS ASPHALT CUT _IT ClJRBCUT _IT SIDEWALK_FT
DRIVEWAY CUT _FT
MA1N CONDlTlON INTERNAL LlNlNG V A TUBERCULA TION-MlNOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE I' ", P.P.M.
WATER OFF FROM Z- P M. TO 2 ZOfiM.
~ntyC1
,
UV(f ~.'\
FROM
M. TO
M.
APPARENT CAUSE OF LEAK. {)(~ Cf(f-