HomeMy WebLinkAbout208 W 7th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
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REQUEST
Date / 0- "/"-0 ,,/
Time / 1('(/7/ A~ Received by
(phone, person)
Location of Work to be inspected ~"B ~ 7 rZ
Name of person requesting inspection vv 4 fer f}; (/
Address of person requesting inspection /7 r"- q f?~r Phone No l.f /7-'{~'/1
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav @ c.-.ti. r -e .r-
INSPECTION NOTES
Inspected Date 10- '/-" '( Time /I,tn/ /l n.. By 71 7
Remarks , e#tc~<4!. C b/o.t~;'"\.. ct//6 ~ toa '-'f..-/ rL-. n? ,s/lIr s Ib~
. , , ,
RESTORA TION REQUIRED YES Y NO
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
o Asphalt 0 PCC ~ Other
Work Order # / </,7 7'0 - e)(s 5-
% COMPLETE
o INCOMPLETE
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(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Department
Water Distribution Repair Report
lWork Order No J 'l.J~ -065 I
JCrew 7/7) 7~ S .lr<<c y
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DATE REPORTED /0 - ~/-o y
Co.NDITIo.N ElvlERGENCY 0 Ro.UTINE ft CITIZEN COMPLAINT 0
LEAKAGE SURVEY 0 o.THER 0
TYPE o.FMAIN
/ a-if - 0 (./
ADDRESS ;2 [ CS
I. Gf
lJ
TlME 7 : 0lJ
~ I Ti.
~.M. OP.M.
DATE o.F REPAIR.
REP AlR Lo.CA TIo.N
:7l \\
SIZE (
"I, r \ ") ..._,
DEPTII o.F MAIN ~ ~ CLo.SEST VALVE DEPTII. 0< J
Co.MPo.NENT REPAIRED.
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL 0 LONG BREAK 0
Ho.LE 0 CLAMP 0 OTIffiR
SERVICE TAP 0 CORP STo.P}t{ PIPE 0 CURB STo.P 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE. FLANGE NUTSIBOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
o.THER.
COMPo.NENTSo.FREPAIR. CLAMPO DRESSERO o.THER /l1~fo/-s1:;f)
,
SITE CONDITIo.N GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA)( SOIL TYPE
CUTS ASPHAL T CUT _IT CURB CUT _IT SIDEWALK_IT
DRIVEWAY CUT _IT
MAIN Co.NDITION INTERNAL LINING / A TUBERCULATIo.N-MINOR 0 SEVERE 0
EXTERNAL Co.RRo.SIo.N Lo.CALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE /f/ A P.P M.
WATER OFF FROM cr (.IV .4M. TO. It) 'oJ AM.
FROM M. TO. M.
APP '\.RENT CAUSE OF LEAK
1(111) Io".J b/~je C~/'~ 5'~~
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