HomeMy WebLinkAbout1928 W 5th St - Engineering
REQUEST
Date j-7-v <)
,
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
Time /;-~ :3 D // ,~ Received by
,
(phone, person)
Location of Work to be inspected /9).13 C-r./ 5" T~
Name of person requesting inspection ~L. ~F ~t/
Address of person requesting inspection /70.3 5 0 ~ sT Phone No c;/7- Cj<Y;</C;
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other ~ q/e ,.,-
INSPECTION NOTES
Inspected Date / - 7 - 0 .s-
Remarks
Time
/ ;;< J Su i/u, By 7 / 7
,
I ~"'~I/eJ ;1''r.!l''11-. .b/-e~ k ; SId" '-'hll br~"" v1e..,,l~ ,..,.,/;",,,,.1
C, X '-{ ~ ;.Je~ I.l etd:s t ~,Jvl00 <::d. 'tC'J e Ii: ~^1 ~> j d.AJ~ (!wJ t-
RESTORA TION REQUIRED - YES )(" NO
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SURFACE RESTORATION-
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
(Continue on reverse side if necessary)
o Asphalt rtcc 21 Other fot :b. /
~J"k Order # :?o 3</;< -C03 ~\q76.ct I
~ COMPLETE A~ \'~~ r~~
J2K1NCOMPLETE
STREET SUPERINTENDENT
(OA TE)
CIty of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No '3 03L/ cJ,- 0(.)-:5 /
JCrew ;/7J 7/6. 7~~
" ,
J
DATE REPORTED
j- 7-0j-
CONDITION E1'vlERGENCY 0 ROUTINE X CITIZEN COMPLAlNT 0
LEAKAGE SURVEY 0 OTB:ER 0
DATE OF REPAIR. I - 7 - c...?'5-
REP AIR LOCATION ADDRESS J 9 ~ 8
TYPE OF MAIN C-L
TIME 7, tY?) 4'1 ~.M_ DP.M_
LJ Sr~
SIZE ~ '\
DEPTH OF MAIN 3 '
7'
CLOSEST VALVE DEPTIl v
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK X SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTIIER
SERVICE T.,1JJ 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITTING 0
lv1ETER SETTER 0 1'vlETER 0
LINE VALVE FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
OTHER.
COTYfPONENTS OF REPAIR. CLAMPO DRESSERO OlliER SS /' ~I__ h~l:ld
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHAL T CUT _FT CURB CUT _IT SIDEW ALK ~FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING ./7/'/1- 11JBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE /?/~ P.P M. .[yeJ C/~.P"r !G''t.I!;,.r",< 1"-e~Sv/-e
WATER OFF FROM M. TO M.
FROM
M. TO
M.
-\pP <\.RENT CAUSE OF LEAK. 61t:? fJ;~-€