HomeMy WebLinkAbout1803 E 4th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUE,ST: i _ '1
Date .9 () t"
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 L0Jc~
l<gb I E t;11
--{WI I (If
I 7111 + Phone No.
INSPECTION NOTES:
Inspected: Date
Remarks:
Time By
m;'r ir ~ -f ~ 0..;1 t\.
w iM .- _ . -ck-c$' R c:: 61..) Q(i_:l
RESTORATION REQUIRED . . . . .. YES
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SURFACE RESTORATION:
SURFACE TYPE: D Unimproved D Gravel
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
o Asphalt 0 PCC /' 7 . 0 Other
Wo~rder # 711
~ COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
..
STREET SUPERINTENDENT
(DATE)
City of Port Angeles
Public Works Departnlent
Water Distribution Repair Report
ICrew:
71v
I
REPAIR LOCATION: ADDRESS:
/g6?
TYPE OF MAIN: :2 r< C -:c SIZE:
DEPTH OF MAIN: fL)l2- ( CLOSEST VALVE DEPTII:
DA.M. lfP.M.
y-/4
COMPONENT REPAIRED:
MAIN: JOINT D CIR. BREAK D SPLIT BELL. D LOJ'lG BREAK ~ /~J x j) /~.# ,., i}/1
HOLE D CLAMP D OTHER Cc1 a 131 ~ &u (J rr -Pa@l G' r H/l UV \..
I
SERVICE: TAP D CORP. STOP D PIPE D CURB STOP D FITTING 0
METER SETTER 0 METER 0
LINE VALVE: FLANGE NUTS/BOL TS 0 STEM D BONNET 0
HYDRANT: BRANCH D VALVE D BARREL 0
OTHER:
COMPONENTS OF REPAIR: CLAMPO DRESS~THER
SITE CONDITION: GRA VEL D ASPHALT D SIDEWALK D CURB 0
TOP SOIL AREA D SOIL TYPE
CUTS: ASPHALT CUT _FT. CURB CUT _FT. SIDEWALK _FT.
DRIVEWAY CUT _FT.
MAIN CONDITION: INTERNAL LINING TUBERCULATION-MINOR 0 SEVERE D
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE P.P.M16
WATER OFF: FROM '7 ( ') U M. TO ClP r<M.
.
FROM M. TO
APP ARE