HomeMy WebLinkAbout818 E 6th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . INSPECTION REPORT. . . . . . . .
REQUEST
Date t/... ? 7 -o'Z
Time
6 A Jvt
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//
/ / 3- in
Received by U E~(~'h:1phOne, person)
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Location of Work to be inspected gig lC. ~-
Name of person requesting inspection D, ~(~Tc:'-"-
Address of person requesting inspectionU ........IJ Y' a... rd Phone No
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Type of Inspection (circle appropriate one) Permit No ~ ~
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Oth~ c~ ; ,,~
INSPECTION NOTES
Inspected
Remarks
Date
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Time
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RESTORATION REQUIRED .
YES X
NO
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
o Asphalt 0 PCC 0 Othe~ 50 (. (
Work Order # 201'1 I AY-e~,-
o COMPLETE
~ INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Departnlent
", ater Distribution Repair Report
~ w - '1)'"t>I- 2oft:j
IWork Order No' ?~
Icrew. 7(G. 7 t'3 7 ('1
I ).J
DATE REPORTED '1- 27... 0'2-
CONDITION EMERGENCY){ ROUTINE 0 CITIZEN COMPLAINT !(
LEAKAGE SURVEY 0 OTIIER 0
REPAIR LOCA TI0N ADDRESS 81?l C
L~Z.
71
G~
MA.M. DP.M.
DATE OF REPAIR. l/ -- 27 - 02.. TIME
TYPE OF MAIN
2. r (
SIZE.
DEPTH OF MAIN
"'71
~
CLOSEST VALVE DEPTH.
2~
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK.k1 SPLIT BELL. 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTIIER
SERVICE TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITTING 0
METER SETTER 0 lvlETER 0
LINE VALVE. FLANGE NUTSIBOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTIIER.
COMPONENTS OF REPAIR. CLAMP)( DRESSERD OTIIER
SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOn.. AREA)( SOn.. TYPE tJ c"-- 1-( v' e...
CUTS ASPHALT CUT _IT CURB CUT _IT SIDEWALK_IT
DRIVEWAY CUT _IT
MAIN CONDITION INTERNAL LINING ,J I A TUBERCULA TION-:MINOR 0 SEVERE 0
EXTERNAL CORROSION {LOCALIZED.l( EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE ~/A P.P.M. F.}( L j 'v €- - '-'to (OSL:? ar f' e<;<:;U r ~
WATER OFF FROM
M.TO
M.
FROM M. TO
APPARENT CAUSE OF LEAK. C; rbvJ
M.
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