HomeMy WebLinkAbout18th & E St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST: / /
Date J-?--- ____-lS --.:1 Time Received by (phone, person)
Location of Work to be inspected J <g +J, +- E:5 +-- IJ f. CO)r /1 J0V
Name of person requesting inspection T VU I' I (lI r
Address of person requesting inspection 17 itt -f.--[3 Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other (j ~ T~;-
Time By
, } (~I:iC;-.' r- 9" ~ C '741; I ~ fJ:~k
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t ......-.....
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INSPECTION NOTES:
Inspected: Date
Remarks:
RESTORATION REQUiRED...... YES
NO
/
V/
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt
o Repaired by City
o Repaired by Permittee
o No Damage Found
1
.~
I ~ ~/J1
~
~
L4
~
~
o PCC. 0 Other
"I Lf 3/s- -06 2-
Wor~er #
~MPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
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City of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No:
DATE REPORTED:
I~ '3/ )'D~
J-;A-6 Y
/Crew:
;11'
CONDlTION:
EMERGENCY D ROUTINE D CITIZEN COMPLAINT ~.
LEAKAGE SURVEY D OTIJER D
J- :;A- 6 l( TIME
ADDRESS 1'1+11 1;- "E- 5+
~(' 4c- SIZE
DA.M. DP.M.
DATE OF REPAIR:
REP AIR LOCATION:
)J f:- C' cJ Y' J0-e/V------
TYPE OF MAIN:
DEPTH OF MAIN:
CLOSEST VALVE DEPTH:
COMPONENT REPAIRED:
MAIN: JOINT D CIR. BREAK D SPLIT BELL D LONG BREAK D
HOLE >( CLAMP D OTIJER
SERVICE: TAP D CORP. STOP D PIPE D CURB STOP D FITTING D
METER SETTER D METER D
LINE VALVE: FLANGE NUTSIBOL TS D STEM D BONNET D
HYDRANT: BRANCH D VALVED BARREL D
OTHER:
COMPONENTS OF REP AIR: CL~SSERD OTIJER
SITE CONDITION: GRAVEL D ASPHALT D SIDEWALK D CURB D
TOP SOIL AREA D SOIL TYPE
CUTS: ASPHALT CUT _FT. CURB CUT _FT. SIDEWALK _FT.
DRIVEWAY CUT _FT.
MAIN CONDITION: INTERNAL LINING
EXTERNAL CORROSION
CHLORINE RESIDUAL SAMPLE I)... 7 P.P.M.
WATEROFF FROM II/!-J1I M. TO ufrJ
TUBERCULATION-I\1lNOR D SEVERE D
LOCALIZED D EXTENSIVE D
. +- o}2- .5--e'I/U' 'c ~
);3loc-J< oU
FROM M. TO M.
APPARENT CAUSE OFLEAK J_ \ '/ ~ V t aJ;'1;~ () R~) J I :;;. pc) !-e-
DIU k~ Z:cl /? Y'Jj( t{J /