HomeMy WebLinkAbout517 E 11th St - Engineering
CIty of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No:;tO:::?~
'e &,;Ter, lb~\Je5
rew _.
~"~()i, ~~6 "
./ \...-'
DATE REPORTED \ - 30 -. ~,~O ..2-
CONDITION EMERGENCY ~ ROUTINE D CITIZEN CONlPLAINT 0
LEAKAGE SURVEY D OTHER D
DATE OF REPAIR. \ -,3'.' - ]....00 :>- TIME:3 ~)O
REPAIR LOCATION ADDRESS 5\, c' \ \-t'h
DA.M. ){P.M.
TYPE OF MAIN CAS-\- ~ror'
\ I
SIZE. ;;t
DEPTH OF MAIN 3 i
CLOSEST VALVE DEPTH. ~. 5
CONIPONENT REPAIRED:
MAIN JOINT 0 CIR. BREAK 'fj. SPLIT BELL. D LONG BREAK D
HOLE D CLANIP 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITTING D
METER SETTER D METER 0
LINE VALVE. FLANGE NUTS/BOL TS 0 STEM D BONNET 0
HYDRANT BRANCH 0 VALVE D BARREL 0
OTHER.
CONIPONENTS OF REPAIR. CLANlPO DRESSERO OTHER .fu.\\ c...(~C.\e. ~\\,( ~,,.,,.J,
SITE CONDITION GRAVEL ASPHALT )l( SIDEWALK D CURB 0
TOP SOIL AREA 0 SOIL TYPE
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT ..l..L-FT
MAIN CONDITION INTERNAL LINING JJ./ A TUBERCULA nON-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED ~ EXTENSIVE 0
CI-ll.'oRINE RESIDUAL SAMPLE P.P.M.
WATER OFF FROM
M.TO
M.
FROM
M.TO
M.
APPARENT CAUSE OF LEAK. ~('o<..\~ se-t.\-\;....J
.....
CITY OF 'PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . . . . .
fJ'7 ry
f'(
.------
REQUEST
Date I -' ,3') :)_0,_' ~
Time
Received by
(phone, person)
Location of Work to be inspected 5 I , E:. I ,-+ j..,."
Name of person requesting inspection ~\<...I,..""",.) ~u~-\-~. r
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other u.-J I\-'r-f':" :--
INSPECTION NOTES
Inspected Date
Remarks R-~..f"c" ~ -e..c:)
\.u.:~\ vQ~
"Ill
(y.
r' .-.-
'- ..L,
Time
~i'" hit. ~AJe<;-\
By
(rP A\ b.--.--1 S-t
t ~ to
d-
tJ (...-s..-
i..-R-A \L.
~ I ~
if" a\$ .(t' ~ ,
+~
-' \ \ -'
~ t: +
c \.
'"' ~)
.- -G
--
~
~ESTORA TION REQUIRED. .. . YES Y NO
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved OGravel ~Asphalt OPCC
o Repaired by City Work Order #
o Repaired by Permittee 0 COMPLETE
o No Damage Found 0 INCOMPLETE
10' Jl;~e f ~//; !tXZ
o Other
~3..L
'-
CITY OFPO.RT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . INSPECTION REPORT. . . . . .
/.~'7ry
JG~1 z03L
..... LIlA-
......
REQUEST
Date I -',30 .)..,00 'L
Time
5'1
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Received by
(phone, person)
E:: I (-+ho
R \<...I,..,,~,- .)
~O'" \- ..e. r
Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other u.-J ~-'r-P....:--
INSPECTION NOTES
By
(J+ A\ be...-\ S-t
Time
~i'" bit. ~e<;-\
Inspected Date
R k R .\ ,,,,d r'.-r_
emar s ~c,,~-e..e,;. _~ '- ~ =
v~:~\vQ_
/
~ESTORA TION REQUIRED YES "" NO
.
l' \'
d-
tJ (...-s..-
l...eft\L.
~ I ~
If-- d.\ 5 .(t' ~ ,
+~
-. \ \ -"
~ 1;:. +
c \.
- ~)
~ -G
-
~
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
'- [] No Damage Found
/1 i~>7r/ ~ J ;?~
(Continue on reverse side if necessary)
~ Asphalt 0 PCC
Wory Order #
[f2( COMPLETE
o INCOMPLETE
o Other
~3..L
I
/{)2~
/
~#II
STREET SUPERINTENDENT
J- () (;- () Z/
(DATE)