HomeMy WebLinkAbout1305 E 1st St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
.....
REQUEST
Date Cj w J.-o -- 0 <-I
Time / I:, dV t1eReceived by
(phone, person)
Location of Work to be inspected -130 5 E '{;,...~r
Name of person requesting inspection Wa... i ~ r LtJ,,,,,,,
Address of person requesting inspection /7 ri... {I? Sr Phone No 'It 7 -,/1(;'-/1
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav ~c-<./c<.. f -e ./
INSPECTION NOTES
Inspected Date 9 - r:HJ -0 </ Time t I <../lJ --::!"" By 7 17 .
Remarks R t' /l ~..- ~ J ,\... .............q. r., r .5 e / (/ ~c.-< .(>" i)~ /n ec. ,.:v, To.me f- -e /'
al'r() x 6\ t 10" cr/T 1J1. &t5pJd,.
RESTORATION REQUIRED
YES Y NO
,
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,
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~
~
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w g"At:. -- .'V
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VI
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Re::... q- 2c~Cf-\
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel ~ Asphalt 0 PCC 0 Other
[] Repaired by City Work Order # IVr.) ~ -t!15 y *'-1S~1 \ Et- J
[]Repaired by Permittee 0 COMPLETE . Av'esJ... \<~d"ec.R vJ\t~\
[]No Damage Found 0 INCOMPLETE ~crt)J\1 V C\- 'Z1-oL\
LC.~ (>/ J t / ~
- If) j-l"ree4 1/~q I ()fT~
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
CIty of Port Angeles
Public Works Department
Water DIstribution Repair Report
IWork Order No /'(;" 7'tr-()61 1
l~rew 7/7. 7/6, 7.)...5
.
J
DATE REPORTED q')..i) -0 (.1
CONDITION E1v1ERGENCY 0 ROUTINE)iC( CITIZEN CO.MPLAlNT 0
LEAKAGE SURVEY 0 OTHER 0
DATEOFREPAlR. q-:)..-o -<":>'l
Tn. AT: <7,' .... ......,
.uv.u:. JL...... "" ~.M. DP.M.
REPAIR LOCATION ADDRESS I.~ 'i .e {',,,'S 1-
TYPE OF MAIN
Ac-
SIZE ~\,\
"->'
DEPTIr OF MAlN :)
~,
CLOSEST VALVE DEPTII. ~
CO.MPONENT REPAIRED.
MAIN JOINT 0 ClR. BREAK 0 SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE)t CURB STOP 0 FITTING 0
lvlETER SETTER 0 lv1ETER 0
LINE VALVE. FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTHER.
Il , 1\ t. ~
COlvIPONENTS OF REPAIR. CLAMPO DRESSERO OTHER I ,c:.~;~~ , 11'16 ~/ .$1.;)//
I " , ,
SITE CONDITION GRAVEL 0 ASPHALT~ SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHAL T CUT ~FT CURB CUT _FT SIDEWALK_FT
DRlVEW A Y CUT _FT
MAIN CONDITION INTERNAL LINING /1/ A TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE ./1/4 P.P M.
WATER OFF FROM
M.TO
M.
FROM
M. TO
M.
<\PP.-'\RENT CAUSE OF LEAK ~jJ. P jJ e
Dc.u- Z-OC) 9' /1 ~1
CITY OF PORT ANGELES
.~ DEPARTMENT OF PUBLIC WORKS
< ........... INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date 1- I [, - d (
Time
Received by
(4' /1
?
(phone, person)
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 Plumbing
IJv:) E Is-!-
~ VU ;'1 ((:.7
I -J t1t Cfr t3
Phone No.
Permit No.
Final Sewer Excav. Other G./a ~
INSPECTION NOTES:
Inspected: Date
Remarks:
Time
,R -ePC( ,y- -< d
!. -etU<-' Lu I -f/1
By
cJJz---e:+-e:v-
4.}-..e-e~
s-pf::r
~ ec r ,51-dPt
,
/'
RESTORATION REQUIRED . . . . .. YES j/ NO
It I 3D> ( 17 f-
jff 5f?rUic-€.
L
~ 'l1"lfc _
.- '- " .
~ r t \(Q1' <
1 s+(
] I
SURFACE RESTORATION: / /'
o Unimproved 0 Gravel ~phalt
o Repaired by City
o Repaired by Permittee
o No Damage Found
o pcc, 0 Other
Work Order # / C; J..-q
~ COMPLETE j}-uJ
D INCOMPLETE 8- 2b - IJ I
SURF;J-VPE:
~ I~Olif
J-oCJ1
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STREET SUPERINTENDENT (DATE)