HomeMy WebLinkAbout4407 Fairmount Ave - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT . . . . . .
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REQUEST
Date I - /o~O<)
Time
7 : 60 4'V1. Received by -7 ( 7
(phone,~rs~)
Location of Work to be inspected Lj tf 0 7 ..fa. If PtcNrlt Av-e
Name of person requesting inspection LJ <t. r e r tJlvJ,
Address of person requesting inspection /70":> So B 5/ Phone No ~/7 -1S17
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav ~ C."..hz-t c v
INSPECTION NOTES
Inspected Date / -{ '6" - 0 )
Remarks
Time
/ :uV hY!
I
By 7 17
~ ~ \l <t"".:7, r' ,,(, v I L I H'1-"
J/L -.:> C v. "'-- eCi< C('~ n/t /l;h
RESTORA TION REQUIRED . . YES NO Y
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved )Q Gravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # :J03c;6 c/V6
fir 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 303Yb-006
I Crew 7 /7 I 7/ b I 7;' J.
J
J
DATE REPORTED
I-/~ -oj
CONDITION EMERGENCY 0 ROUTINE IX' CITIZEN COMPLAINT 0
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR. I - f 8 - 0) TIME I J. ; uu
REP AIR LOCATION ADDRESS Lj lj () 7 -J: I r /J1 O//rt T
TYPE OF MAIN /I C SIZE 11 "l
DEPTII OF MAIN d.' CLOSEST VALVE DEPTII.
OA.M~.M.
Av-e
COMPONENT REP AlRED.
MAIN JOINT 0 Crn.. BREAK 0 SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE TAP 0 CORP STOP 0 Pll'E Ai' CURB STOP 0 FITTING 0
Iv.lETER SETTER 0 METER d\
LINE VALVE. FLANGE NUTSIBOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTHER.
COMPONENTS OF REPAIR. CLAMPO DRESSERD OTHER .,)1 WH"Ip. ~ UV1I,.,h.-
I
SITE CONDITION GRA VEL)( ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHAL T CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING /1/ A TUBERCULATION-MINOR C SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE /Y /I P.P M.
WATER OFF FROM
M.TO
M.
FROM
M.TO
M.
APP,\RE?'<T CAUSE OF LEAK. Ow Pe: (J.iN!
,