HomeMy WebLinkAbout208 Dolan Ave - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . INSPECTION REPORT. . . . . .
'Dw -.2001- 1~83
REQUEST
Date q --.-q - O()
Time
Received by
(phone, person)
Location of Work to be inspected V 6 I
Name of person requesting inspection ' c..~ , I C 6
Address of person requesting inspection /1 f/i tr ~ Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
~
~
INSPECTION NOTES
~
:J
Inspected Date
Remarks
Time
1< it-? A I \r -i.. -€//t l:
/J ,~ I
By
('~ t
-
~Q~
RESTORATION REQUIRED
YES
NO /~
JJt{\
( ~ {)() I ctl1
rl"] 7..<( -,
."'" ;b '~
I'"'"
t~ ~
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
o Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC
Wor~r #
[j450MPLETE
o INCOMPLETE
J 0 Other
6~1
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
DW. 2.00 T ~ f (p 6"3
City of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No: I ~ ~ ')
Reported: 3-1 ~ Q 0 Condition.
Repaired: !J-I ];/-G- C> Source:
Repair Location.
Address.
Loc. Description.
Component Repaired:
Icrew:
7/t/
. I
Emergency Routine
Citizen Complaint L/'
Leakage Survey _ Other
?6<6
,D () / C{ J//
Main Line ID#:
Main: Joint Cir Break
Long. Break _ Hole
Service: Tap _
Line Valve: Flange Nuts, Bolts
Hydrant: Branch
Other:
Repair Type: Clamp _
Site Condition: Surface
Curb
Damage:
Split Bell _
Clamp _
Other
Corp. Stop _ Pipe _ Curb Stop _
Stem Bonnet
Valve Barrel , 1--
-m1 ~/f-er S-e I (--e J/
Dresser Other f( -eb U 7 '1 c! /Sa. c;K $ {2J Ul
o {Z <fl-t0-j&v-
Gravel Roadway _ Asphalt Street _ Sidewalk
Top Soil Area _ Soil Type ~
Cuts: Street Cut: Ft.
Sidewalk Cut: Ft.
Main Condition:
Curb Cut: Ft.
Diameter- Inches
Material.
Depth of Cover- Ft.
Internal Lining:
Tuberculation: N/ A
External Corrosion. N/ A
Special Conditions: Bedding:
Other Structures:
,.
".-,
Joint Type.
External Prot:
Minor
Localized
Severe
Extensive
Samples Taken: Pipe Section _ Coupon ---.AI tJJ.J-t<-
Water Off: From3.....JLoo To J 2. PM } h6 U >-1L
From~/6-W TO~M } hV (
f( (j P 11 9 0. /1) ·
Apparent Cause of Leak:
ou+-
5/19/98
Page 1
PW-902.09