HomeMy WebLinkAbout3800 Park Knoll Dr - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS 1\
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST: f) \
Date q ~ I D- 0 i.( Time I/" '0 A<1.. Received by V6tVl (5 E- (phone, person) \
Location of Work to be inspected W ~< k 'V1..lJ ( C/',
Name of person requesting inspection 1/I/1/S E,
Address of person requesting inspection CorP ItA r.
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Type of Inspection (circle appropriate one):
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t7 'b- B Phone No. if tj - <{?'-f 9
Sewer Foundation Framing Chimney Plumbing Final
Permit No. -
Sewer Excav. OthC~~+e0
INSPECTION NOTES:
Inspected: Date "7' -: /0 - 0 tf
Remarks: f(e.Llc.... I y 3/<("
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Time g.~ S-o PIvL By lie""....; c; E .
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RESTORATION REQUiRED...... YES X NO
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SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
t./ I' 'K 7 ' ~ec.. <1- \'E;"-0
lKl Asphalt 0 PCC 0 Other
Work Order # I'{ 278 -ora I ~~bC{O If:- J
o COMPLETE ~ t-e.{l""'\~ \.lJ\'\~
o INCOMPLETE ~&t' M~x Q-1o<:JY
/10 Sired!
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(Continue on reverse side if necessary)
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City of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No: 1'I2.?8 - ()(, I
lerew: 7 (5"" q...- Cre...;
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DATE REPORTED:
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CONDrTION ElvlERGENCY 0 ROUTINE 0 CITIZEN COlvlPLAINT ~
LEAKAGE SURVEY 0 OTHER []
DATE OF REPAIR c:r - I () -04
REPluRLOCATION: ADDRESS: :5'tao
TIlvlE: . II : 3D J(A.!vL []P.M
fAr k. {.(~ci ( Dr.
,. I 2 (f
TYPE OF MAIN: '--- -. SIZE:
y,l r 7r
DEPTH OF MAiN: ~'-'f CLOSEST VAL VE DEPTH: ::;J
COlvlPONENT REPA.IRED:
MAIN: JOINT 0 CIR. BREAK 0 SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLPuVlP [] OTHER
SERVICE: TAP [] CORP. STOP 0 PIPE J:( CURB STOP 0 FITTING 0
METER SETTER [] METER 0
LINE VALVE: FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT: BRANCH 0 VALVED BARREL 0
OTHER:
COlvlPONENTS OF REPAIR: CLAMPo DRESSERo OTHER -0/4 {a-I L),.(.f~Vl ,itts.e,;;<; , ~. -t ub,~
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SITE CONDITION: GRAVEL [] ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS: ASPHALTCUT't'x7'FT. CURB CUT _FT. SIDEWALK _FT.
DRliiEW A Y CUT _FT.
MAIN COl'iDmON: INTERNAL LINING tl/A TIJBERCULATION-MINOR [] SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORlNE RESIDUAL SAMPLE .. Z Z PPM.
WATER OFF FROM 2-: (t) ~ M. TO 2 30fl M.
FROM
M. TO
M.
Al'P.A.RENT CAUSE OF LEAK:
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