HomeMy WebLinkAbout500 Blk W 14th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
,- /. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST: I U
Date ) - ~ b- D -\ Time
Received by
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other ~
L)DO B) k W ll\-th.
-r'V-' ,'\ Co )u
Ll.(tL {--{2- Phone No.
INSPECTION NOTES:
Time By
"/Q..,-fP C1 J L' C o~~ y-
5 -f' IV U I ? ~ ISJ..~ (' d y f) <--ft\P
~y ilk Plp\y r r"e ( d " ' -"
c..,,/ ~---------'
RESTORATION REQUIRED. . . . .. YES N~ ~-
"
Inspected: Date
Remarks:
---,
tAl -.
J1.
f
l ) LI fh ,
f)rfJ-.
I
IO'~ ~ "'"
\ i
It r~r: ( .....
,} to -L~ ~
~~('{~~P1'}Y
~
----
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
o Other16P% \' ~
J~')..1~ - aD ({
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel 0 Asphalt 0 PCC
~W~
J /.
M/1/tJ1fr
STREET SUPEI'lINJENDENJ
(Continue on reverse side if necessary)
(DATE)
City of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No: ILl ?..,q-ODL(
,
lerew:
7/1
DATE REPORTED I-~ -0 Z/
CONDITION: EMERGENC~ 0 ROUTINE 0 CITIZEN COMPLAINT ~
LEAKAGE SURVEY 0 OTHER 0
REI' AIR LOCA nON: ADDRESS:
DATE OF REPAIR: ,J ~ 2j-oL( TIME
0-06 (] Jt<.
TYPE OF MAIN: )0 t' .11- C- SIZE:
OA.M. OPM.
h) Jf/ f/J
. r
5-f>vu/2-.e
CLOSEST VALVE DEPTIi:
)ClVM SI-;j-e
fo JiAK5 j
;/1; r:/~/
DEPTIi OF MAIN:
COMPONENT REPAIRED:
MAIN JOINT 0 ClR. BREAK 0 SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE: TAP 0 CORP. STOP 0 PIP~URB STOP 0 FITTING 0
METER SETTER 0 METER 0
LlNE VALVE: FLANGE NUTS/BOLTS 0 STEM 0 BONNET 0
HYDRANT: BRANCH 0 VAL VE 0 BARREL 0
OTHER:
COMPONENTS OF REI' AIR: CLAMPO DRESSERO OTHER
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.
DRJVEWAYCUT _FT.
MAIN CONDITlON: INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORJNE RESIDUAL SAMPLE P.PM.
WATER OFF: FROM M. TO
1 )}<-
M. {-,'x-ed /-1
FROM
M. TO
r
M.
Xo /l--e/l)
CQi/JP~V ;/jP-R-
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APPARENT CAUSE OF LEAK: