HomeMy WebLinkAbout828 W 15th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT. . . . . .
.....
REQUEST
Date ...:)..;2 G )~
Time
yell /J h"1 Received by 71 7
(phone,~;so~!:
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Location of Work to be inspected (5). '?/ ~ / <) 1 L....
Name of person requesting inspection L.-z/~t r.... r t?t v ,
Address of person requesting inspection / 70 J , '5 r') i? Phone No V/7 - '-/y $-17
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav c9'~ ~G tE' ,r
INSPECTION NOTES
Inspected Date ;) -;2 - 0 S-
Remarks
Time /1, Jl} 4;., By 7/ 7
1
I ( i?/I P.'l./ "I i2./ I/' Ie < J/71Cl '" "L t ~ J /l e It" .r-
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RESTORA TION REQUIRED YES X NO
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
o Asphalt 0 PCC ~ Other
Work Order # 303'1b - CO)
,
o COMPLETE
)(2 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 )qJ (/6- 007
JCrew )17.7/5-, '//6, ~'p(, /r;,t:?J
./ I , '" _
DATE REPORTED /-'3/-0 5-
CONDITION E1v1ERGENCY 0 ROUTINE X CITIZEN COMPLAINT 0
LEAKAGE SURVEY 0 OTIiER 0
DATE OF REPAIR.
?- ) - <,.....;
TYPE OFMAlN
ADDRESS 'S;< CJ
C-Z
b' CLOSEST VALVE DEPTH.
TTh1E 0' ; (fl:;'
u/ fS'TL,
YA.M. OP.M.
REP AIR LOCATION
r? I'
SIZE '
DEPTH OF MAIN
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.....
COMPONENT REPAIRED.
MAIN JOINT 0 Crn.. BREAK 0 SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTI1ER
SERVICE TAP 0 CORP STOP 0 PIPE~ CURB STOP 0 FITTING 0
METER SE1TER 0 METER 0
LINE VALVE FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTI1ER.
COMPONENTS OF REPAIR. CLAMPO DRESSERO OTHER .J11E f,,?f" ~ /I'k!;-r S/~
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA)( SOIL TYPE
CUTS ASPHAL T CUT _FT ciJRB CUT _IT SIDEWALK_FT
DRlVEW A Y CUT _FT
MAIN CONDITION INTERNAL LINING /f/ # TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE /j/ 4- P.P M.
WATER OFF FROM
M.TO
M.
FROM
M. TO
M.
~PARENT CAUSE OF LEAK.
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