HomeMy WebLinkAbout602 E Lauridsen Blvd - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT. . . . . .
Ow ;J.~OI-/s/r
REQUEST
I?- - ")C)_ 91
Date r f
/
Time
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r.(I~
Received by 1\ tJ N
(phone, eerson)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney
&; (I /- E $//"- L/
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Phone No
Permit No
Plumbing Final Sewer Excav
Other
UJO. 15/'1
INSPECTION NOTES
Inspected Date /.?- ~?- 9 - Y 7
Remarks
Time ') ~ 317 ~M By ,/:'I/,;{/
RESTORATION REQUIRED
YES v- NO
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X 5 CRI/IC E
SURFACE RESTORATION:
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
D Repaired by City
D Repaired by Permittee
D No Damage Found
Work Order #
o COMPLETE
[j-1NCOMPLETE
o Other L /J j/V 1/
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IV E E fJ f T rJ f' . . S {i! L cr ~~ ;1 5' S' .5 E E 1/
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11"'""+;,,,,0 nn rovAr!l;F!!I;i e if necessary) STREET SUPERINTENDENT
(DATE)
City of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No:
Icrew: If tIN,,t7 E/VN 1'). A' Ie H,1J?4
I '7 / <-t-
Reported: f ?-/ ? 1(/ 9 <')
Repaired: /}./ ;...1/'11
Condition: Emergency ~ Routine
Source: Citizen Complaint
Leakage Survey _ Other
Repair Location:
GO)- E 5vr..v-
I
Loc. Description: I if W E S,- v F 1/ d r.. i/ E.
OF IlL8EI\r <f' !Jt/Lt/.
CIA!
) E c{, /Z-A/ c rz
Address:
Component R~aired:
Main Line In#:
Main:
Joint Cir Break
Long. Break _ Hole
~
Split Bell _
Clamp _
Other
Service: Tap_
Line Valve: Flange Nuts, Bolts
Hydrant: Branch
Other:
) Repair Type: Clamp V
Site Condition: Surface
Curb
~ Damage:
Cuts: Street Cut: Ft.
Main Condition: Diameter
Material.
Depth of Cover'
Internal Lining:
Corp. Stop _
Pipe _
Stem
Barrel
Curb Stop _
Bonnet
Valve
Dresser
Other
Gravel Roadway _ Asphalt Street _ Sidewalk
Top Soil Area L.~ Soil Type _
Curb Cut: Ft.
Sidewalk Cut: Ft.
~
Inches A
C -
~.
Ft. J I'
"
Joint Type:
External Prot: ? I T 7 C P
..,...~C
Tuberculation: NI A
External Corrosion: NI A
Special Conditions: Bedding:
Other Structures:
Minor
Localized r...----
Severe
Extensive
Samples Taken: Pipe Section _
Coupon _
Water Off:
From
From
I 1
---
1 1
---
To
To
M
M
Apparent Cause of Leak:
rlrt
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5/19/98
Page 1
PW-902.09