HomeMy WebLinkAbout333 E 10th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT. . . . . .
.....
REQUEST
Date /2 ~ (rc ' u ,(
Time II ;~, A J1/{ Received by YC'nHI5 ~ (phone,.eerson)
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Location of Work to be inspected . "> :> S ;-
Name of person requesting inspection j)~ /' M. I '5
Address of person requesting inspection 0'- vO ~c.{...-d
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Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Othere~ -f-e~
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Phone No
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INSPECTION NOTES
Inspected Date YCv t v1, S E.
Remarks 12. t? /'c"- I > ~ J
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i:7 c'd1.d. 2 '3 -:;-. - 2~ G :;
Time 2- 30 Ylvt
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RESTORATION REQUIRED
YES X
NO
SURFACE RESTORATION 5"x ~
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC ~Other COvtc re+e
o Repaired by City Work Order # 13r~r- 1/ ~6{q'1t. tt- (
[] Repaired by Permittee l?5 COMPLETE A.~ ~c.,~C:\,\ ~~
D No Damage Found 0 INCOMPLETE
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(Continue on reverse side if necessary) STREET SUPERINTENDENT
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(DATE)
City of Port Angeles
Public Works Department
Water DIstribution Repair Report
IWork Order No 1'3'32'3 -o'-l I
Icrew 7 I -:; cf-- C re..J
DATE REPORTED / z. -fro 6'4
CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN CONlPLAlNT )(
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPi'\IR. I Z ~ I&.- 0'-1 TIME !f 'SL' AA..M. DP.M.
3~':; E: --tk
REP AIR LOCATION ADDRESS (0 -
TYPE OF MAIN C -L SIZE 21' -
'"71 f
DEPTH OF MAlN ~')Z CLOSEST VALVE DEPTH. 3
COrv1PONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK pa::: SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLANlP 0 OTHER
SERVICE. TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITTING 0
:METER SE1TER 0 :METER 0
LINE VALVE. FLANGE NUTSiBOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVE 0 BARREL 0
OTHER.
CONlPONENTS OF REP AIR. CLANlPk DRESSERD OTHER
SITE CONDITION GRA VEL 0 ASPHALT 0 SIDEWALK ~ CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRlVEWAYCUT _FT
MAIN CONDITION INTERNAL LINING It../ / It TIJBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION 'LOCALIZED 0 EXTENSIVE 0
CHLORlNE RESIDUAL SA1\.1PLE !J:/A P.P M. h ")(€d (f vie...
WATER OFF FROM
M.TO
M.
FROM
\1. TO
M.
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APPARENT CAUSE OF LE.'\K (5) revlAd ~l.l "-