HomeMy WebLinkAbout11th & Tumwater Trk Rte - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date ! - U- D t( Time Received by (phone. person)
Location of Work to be inspected /Ifh 1r Tc.J V>14J~.A'- t-rk R +-
,
Name of person requesting inspection rW I I (r'Y-y:
Address of person requesting inspection '11 t:h t.- /? Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other ~
INSPECTION NOTES:
Inspected: Date
Remarks:
Time
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RESTORATION REQUIRED. . . . .. YES
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NO
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SURFACE RESTORATION:
SURFACE TYPE: D Unimproved DGravel
D Repaired by City
D Repaired by Permittee
D No Damage Found
D Asphalt D PCC J D Other
Wor~rder # Lf '3 t S-
!kr1:0MPLETE
D INCOMPLETE
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City of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No:
REPAIR LOCATION: ADDRESS:
:0"
TYPE OF MAIN: t1
I Lf '3 }')- 00rl
DATE REPORTED ) - ) () - G Y
CONDITION: ElvlERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT /
LEAKAGE SURVEY 0 OTIlER 0
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DATE OF REPAIR: 1-) I ~ 0 ( TIlvlE
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c - 1-- SIZE
lerew:
;171
7')6 rV
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DEPTH OF MAIN:
)5'
CLOSEST VALVE DEPTI!:
COMPONENT REPAIRED:
MAIN: JOINT 0 CIR. BREAK 0 SPLIT BELL 0 LONG BREAK 0
HOLE~ CLAMP 0 OTIlER
SERVICE: TAP 0 CORP. STOP 0 PIPE 0 CURB STOP 0 FITTING 0
lvlETER SETTER 0 lvlETER 0
LINE VALVE: FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRAt'IT: BRANCH 0 VALVE 0 BARREL 0
OTIlER:
COMPONENTS OF REPAIR: CLAMPO DRESSER~TIlER
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SITE CONDITION: GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS: ASPHALT CUT _FT. CURB CUT _FT. SIDEWALK _FT.
DRIVEWAY CUT _FT.
MAIN CONDITION: INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE
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WATER OFF: FROM
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FROM
APPARENT CAUSE OF LEAK:
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