HomeMy WebLinkAbout719 E 10th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT. . . . . . .
REQUEST
2 - '-( -0 5
Date
Time 10 '00 AJ...'
Received by Ben) e..-
(phone, ~
". fL
Location of Work to be inspected 1/1 c I 0
Name of person requesting inspection 'Be:)1 e. P-lD re.5,
Address of person requesting inspection C()\-P 10.. rA. n ~ B
Type of Inspection (circle appropriate one)
Phone No If-( 7 - Lf cg 'f-C}
Sewer Foundation Framing
Chimney Plumbing Final
Permit No
Sewer Excav @i l,.Je\.,. t-e--r
INSPECTION NOTES
Inspected Date ;). ~ L-/ - 0 '5
Remarks '2" Iv\CAi V\ rer/:>-\ r
Time 2-' CO rrv\ By 8t?~ ~le...-
VJi'K DreS5e~ covrll"~5 Avt({ PVC f'Pe..
RESTORATION REQUIRED
tfJ
7'Q
YES
NO 1<
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2. " ct:
2~"Deep
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
D No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # 3 0 '3 Lf Z - 0 I J
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
City of Port Angeles
Public Works Department
Water DIstribution Repair Report
IWork Order No 30~'i2. - 0/7
I Crew 7/ to Cl~ cre.v
DATE REPORTED J- - L.j - 05
CONDITION EMERGENCY D ROUTINE D CITIZEN COtv1PLAINT D
LEAKAGE SURVEY D OTHER D
REF AIR LOCATION
2 - 'i -05 TI1v1E 12.00
ADDRESS 7 I q E 10 rt--
OA.M. .8lP.M.
DATE OF REP AIR.
C f SIZE 2 'f
TYPE OF MAIN A.$ I TO VI
"
DEPTI-! OF MAIN 2- 'if CLOSEST VALVE DEFTI-!. I 2. "
COMPONENT REF AIRED.
MAIN JOINT 0 CIR. BREAK ~ SPLIT BELL 0 LONG BREAK D
HOLE 0 CLAMP 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITTING 0
METER SEITER 0 METER 0
LINE VALVE. FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTIIER.
COtv1PONENTS OF REPAIR. CLAMPO DRESSER,l1(l OTIIER '2.' S<::.L... ~o fife.. fJfe.
SITE CONDITION GRA VEL 0 ASPHALT 0 SIDEW ALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHAL T CUT _IT CURB CUT _FT SIDEW ALK _FT
DRIVEWAY CUT _IT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SA!vfPLE P P M.
WATER OFF FROM
M.TO
M.
FROM
M. TO
M.
!\PPARENT CAUSE OF LEAK.