HomeMy WebLinkAbout1400 Campbell Ave - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT . . . . . . . .
REQUEST
Date q-g-o~
Time 12 ~~
':'-,./..; '-t ",,'( <:: _F
Received by !L,,---~ ~l ~ (phone, person)
Location of Work to be inspected /'l-OQ Bi k Cl>\"""-" h.td (
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Name of person requesting inspection I ~ VlVl f.c:; t:.-
Address of person requesting inspection L<J-rp t/.."'-rd
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Type of Inspection (circle appropriate one)
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Sewer Foundation Framing
Chimney Plumbing Final
Phone No -!-11 Af~tfcL
Permit No .~
Sewer Excav O~~
INSPECTION NOTES
Inspected Date L/ -- 8 ., 0 L(
Remarks
Time
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By [)et.1.vt I S
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RESTORATION REQUIRED
YES
NO X
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3 'Pee/) 2"CI d ...
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. 6fy.-,~.~~1 ~J. ~ C a""thd( Ave
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # /38 z& -0/7
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Department
Water DIstribution Repair Report
IWork Order No' 138 Z8-0/7
'Crew 7/s c.t- Gre.v
J
DATE REPORTED .3 -/~ "'oLt
CONDITION EIvtERGENCY D ROUTINE D CITIZEN COMPLAlNT D
LEAKAGE SURVEY It\. OTHER D
DATE OF REPAIR. '-f -- g -Ol.f TTh1E. 'COO DA.M. ~.M.
REPAIR LOeA TION ADDRESS I cfoo BI k E _ Gt."",~~e { (
I
"c..r SIZE Zlf
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DEPTH OF MAIN --:> CLOSEST VALVE DEPTII. 2. L
TYPE OF MAIN
COMPONENT REPAIRED.
MAIN JOINT D CIR. BREAK)( SPLIT BELL D LONG BREAK D
HOLE D CLAMP D OTHER
SERVICE TAP 0 CORP STOP D PIPE 0 CURB STOP 0 FITTING 0
IvtETER SETTER D METER 0
LINE VALVE. FLANGE NUTS/BOL TS D STEM D BONNET D
HYDRANT BRANCH D VAL VE D BARREL D
OTHER.
COMPONENTS OF REPAIR. CLAMP)( DRESSERD OTHER
SITE CONDITION GRAVEL D ASPHALT 0 SIDEWA.LK 0 CURB 0
TOP SOIL AREA D SOIL TYPE tVllt,'v'~ - 0(....1 RoJ~
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING I\J-A ~ TUBERCULATION-MINOR D SEVERE D
EXTERNAL CORROSION LOCALIZED D EXTENSIVE D
CHLORINE RESIDUAL SAMPLE . '32- P.P.M.
WATER OFF FROM 1-00 PM. TO 1.15 JOM.
FROM M. TO M.
APPARENT CAUSE OF LEAK. 6rovYli Sdf{ (...