HomeMy WebLinkAbout428 E Orcas Ave - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT . . . . . .
REQUEST: .
Date /Z~2-5'-o'f
Time ~ ID:-I~ /If'1 Received by VC.t",:'" E (phone, person)
Location of Work to be inspected Lf L 8 C 0". G.,- S
Name of person requesting inspection D~Y\."'-; S S-
Address of person requesting inspection /"~ vP Yo... r.) { 7 <f- 13 Phone No. 4. / (- If 81{ 4
Type of Inspection (circle appropriate one): Permit No. ~
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Ot~~ )
INSPECTION NOTES:
Inspected: Date 12- 75 -OL{
Remarks: ReOa:re.J. 2" c.r.
I
Time
~.V\ hrea..!:::
By
L<J ,'+-k. "'-
5-5.
0" t)c. ;.- l-xt ",A;
I
RESTORATION REQUIRED . . . . .. YES
NO X
I ~
,1
.....
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o n.:tA '5 !-lJe.. .
'A. ~H1 ~
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SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved j8!'Gravel
o Repaired by City
o Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # 13 'l5z'ij ~ Dtf1-
o COMPLETE
o INCOMPLETE
',...."".....i................ .................. _:..I....:.r .......^^.........~..,
City of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No: 1'3 'ilz 8 - tJ<{2--
lerew: 7/'CJ + Cve-v
DATE REPORTED /2 - 2S-- 0 'f
CONDITION ElvlERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT ):[
LEAKAGE SURVEY 0 OTIlER 0
TIME: /: IS
REPAJR LOCATION ADDRESS 1.f2&' DrCo.'? Ave....
C - I . SIZE 2' I
DATE OF REPAIR:
I Z - z<; -oy
DA.M. J*M.
TYPE OF MAIN:
. I
2~
DEPTII OF MAlN: ..;;> ~
CLOSEST VALVE DEPTII: .3 '
COMPONENT REPAIRED:
MAIN: JOINT 0 CJR. BREAK ji SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTIlER
SERvlCE: TAP 0 CORP. STOP 0 PIPE 0 CURB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE: FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT: BRANCH 0 VALVE 0 BARREL 0
OTIlER:
COMPONENTS OF REPAIR: CL~ DRESSERO OTIlER
SITE CONDITION: GRAVEL fi( ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE 1Jc..+;vL.
CUTS: ASPHALT CUT _FT. CURB CUT _FT. SIDEWALK _FT.
DRlVEW A Y CUT FT.
MAIN CONDfTION INTERNAL LINING AliA. TUBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION f LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE Ai/A PPM. ,..-- J J
r tXe. '.' .; v'e. ,
WATER OFF FROM M. TO M.
FROM M. TO M.
APPARENT CAUSE OF LEAK GrO v l'td ~tl-I e