HomeMy WebLinkAbout3rd & Oak NE - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST:"""if 7J
Date )- ACP- b -L- Time Received by (phone, person)
Location of Work to be inspected 3 "r) &-. J Ak jJ-Y c.6YYI- e;y-
Name of person requesting inspection TLU J' J (6 If
Address of person requesting inspection / (:tit '6-- /:). Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other 'WCA-+-cr
INSPECTION NOTES:
Inspected: Date Time
Remarks: " R~""I \- fJ.,"
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By
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RESTORATION REQUIRED . . . . ." YES V NO
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SURF~CE RESTORATION: ,V
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SURFACE TYPE: 0 Unimproved OGravel ~It
o Repaired by City
o Repaired by Permittee
o No Damage Found
OPCC o Other 77Jr.:JCj~) ~
,
Work Order # ! j ~2.??' 00 I
o COMPLETE
o I COMPLETE
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City of Port geles
Public Works D partment
Water Distribution epair Report
IWork Order No;
DATE REPORTED:
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TYPE OF MAIN:
:;)" c -j: SIZE
EN COMPLAINT ~
CONDITION EMERGENCY 0 ROUTINE 0 CIT
LEAKAGE SURVEY 0 OTHER 0
DATEOFREPAffi: 1- A,'7-6 V- TIME
DA.M. DPM.
REPAJR LOCATION: ADDRESS:
DEPTH OF MAIN:
CLOSEST VALVE DEP1B:
COMPONENT REPAIRED: /"
MAIN: JOINT 0 CJR. BREAK ~PLIT BELL 0 L NG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE: TAP 0 CORP. STOP 0 PIPE 0 CURB S OP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE: FLANGE NUTSIBOLTS 0 STEM 0 B NNET 0
HYDRANT: BRANCH 0 VALVED BARREL 0
OTHER:
COMPONENTS OF REPAffi: CL~RESSERD OTHER
SITE CONDITION: GRAVEL 0 ASPHALT 0 SIDEW K 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS: ASPHALT CUT _FT CURB CUT _FT. SIDEWALK_IT
DRlVEW A Y CUT _FT.
MAIN CONDITION: INTERNAL LINING TUB RCULATlON-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORlNE RESIDUAL SAMPLE
P.PM.
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M.
WATER OFF FROM
M.TO
FROM M. TO
M.
APPARENT CAUSE OF LEAK:
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