HomeMy WebLinkAbout917 Benjamin Ave - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . INSPECTION REPORT. . . . . .
REQUEST
Date t.f- -- t ~ -0 Lf.
Time 7:00 AU1... Received by Det-'Ul (S E. (phone, person)
-
Location of Work to be inspected 711 ~1'e: VtA:~J
'7J ~J L
Name of person requesting inspection J/evttrt/S c:-.
Address of person requesting inspection 4rt ~~rJ
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing Final
Phone No '117..1./ ~<'{4
Permit No
Sewer Excav Other@~)
INSPECTION NOTES
Inspected Date 1- ( ~ /otf Time I Z j/ M By f) ttt/1l-5 E
Remarks t<.~ IJ 1"'-. <-e $erV(~-e (/~ ~t"'V rvt VV'\..a. l II\. To M l +~. 1,c.J:-LL
a r I \' 'S ". IlE I-
I 0 T y~ ~ _ -r(')i:7I~.
RESTORATION REQUIRED
YES
NO )(
"Jl~", 1< a.rec- -
.............
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"t'- ?' ~
Z r, ,aVL- ~ / tJu-fJ "'
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15-e-~ l~",^t ~
SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel
D Repaired by City
o Repaired by Permittee
o No Damage Found
o Asphalt D PCC D Othe~Sd i (
Work Order # 17777 ~ DO (
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Departnlent
Water Distribution Repair Report
IWork Order No (7777 --()O(
ICrew ties- 'i- cre0
DATE REPORTED
3-11-0Y
CONDITION
EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT 0
LEAKAGE SUR~Y X OTHER 0
t...f -! '5 - () t..{ TIME / L ' On DA.M. ~.M.
ADDRESS 9/7 &~~jIvl..( ~
~ 1/ L SIZE 2-(1
DATE OF REPAIR.
REPAIR LOCATION
TYPE OF MAIN
r
DEPTH OF MAIN c3
( (
CLOSEST VALVE DEPTH. 2... -L
COMPONENT REPAIRED.
MAIN JOINT D CIR. BREAK D SPLIT BELL D LONG BREAK 0
HOLE D CLAMP 0 OTHER
SERV1CE TAP D CORP STOP 0 PIPE)( CURB STOP 0 FITTING 0
METER SETTER D METER D
LINE VALVE. FLANGE NUTS/BOL TS D STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE D BARREL D
OTHER.
a I' A f" 3 /u /J_E .-I-, / ,~
COMPONENTS OF REPAIR. CLAMPD DRESSERD OTHER - I (;./;- T r. (v'tt:? 0
SITE CONDITION GRA VEL 0 ASPHALT 0 SIDEWALl;<. q CURB D
TOP SOIL AREA)( SOIL TYPE ~c.... TI vt:...-
CUTS ASPHAL T CUT _FT CURB CUT _FT SIDEWALK FT
DRIVEWAY CUT FT
MAIN CONDITION INTERNAL LINING ( VA TUBERCULATION-MINOR D SEVERE 0
EXTERNAL CORROS~ED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE l/A-P.P.M.
WATER OFF FROM M. TO M.
FROM
M.TO
6rtffl e.
M.
APPARENT CAUSE OF LEAK.
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I I
-o(&? ac1'
-...."""""." . l...r un I
of
Leak #-.
~
.~~
\
Client 5bR'i f'+IlJC l~ {;-~S
I
Location
Date'" -3 '-1 Cj - d (/
;..
=
Time In. I) 35~~ TIme Out I'J' '50p~Total Time I 71i~
.....
Estimated GPM' e ,~ ,")
Leak Classmcation:
Set-up DIagram
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~
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LIG~ ,<
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f{'~
vC
---. ~~...
------...--
5<=-~~~ AvE"
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(,tlt<....
Site marked. Y I j
Leak Type: Main _ HYd_
Service Une Valve
Meter -X-' Curbstop_
Service Connection
Consumer Side
Undefined Other
Cover Type:
Asphalt _ Concrete
Soil Gravel
Correlations
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