HomeMy WebLinkAbout824 W 4th St - Engineering
CITY OF PORT ANGELESUtN2CX.Y1-/~~b
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST:
Date ~ - 14- Db
Time
Received by
(PhOJ person)
Location of Work to be inspected ~ ;t L( LJ l..( ~
Name of person requesting inspection T w i ( lIl> 'f
Address of person requesting inspection 17 fP '6:: 13 Phone No. ~
Type of Inspection (circle appropriate one): w.6~flermit No. I sY
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other J.U lA....-.-N
INSPECTION NOTES:
Inspected: Date
Remarks:
Time
'/tt x4g ~~-
I
By
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5-e r f.,/, 2-
of!-
/
RESTORATION REQUIRED . . . . .. YES t/ NO
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t> 102-
~( c-y I -
1 I f
J-b 5' ~
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4t'h IHI-e y A
r ~
SURFACE RESTORATION: /' ,
SURFACE TYPE: 0 Unimproved 0 Gravel !J?Asphalt 0 PCC 0 Other '76~.s ~ , 1-
o Repaired by City Work Order # I~
o Repaired by Permittee 0 COMPLETE' fJ- ("AJ ~ 6
o No Damage Found 0 INCOMPLETE
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f-!rect
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City of Port Angeles
Public Works Department
Water Distribution Repair Report
Dw2.oO/- (~ <-I~
'Work Order No: 1,'L( i I , Crew: jlr ,
Reported: 9-1 iO I OD Condition: Emergency Routine V-
Repaired: ~I Jill 0 b Source: Citizen Complaint ~
Leakage Survey _ Other
Repair Location: Address: 2 J-({ tv l(~4
Loc. Description:
Component Repaired: Main Line ID#:
Main: Joint Cir. Break Split Bell _
Long. Break_ Hole Clamp _ Other ./
_..t/~- -
Service: Tap_ Corp. Stop _ Pipe V Curb Stop _
Line Valve: Flange Nuts, Bolts Stem Bonnet
Hydrant: Branch Valve Barrel
Other:
Repair Type: Clamp _
Damage:
I 4'
Street Cut: Ft. "7 'f. Curb Cut: Ft.
Dresser Other ;(.R. ft/-e c0 r:: ?I /J C( c:k 0 F- 9J.t-e.f-ey
Gravel Roadway Asphalt Street ~ Sidewalk
Top Soil Area .t;.../ Soil Type _ -
Site Condition: Surface
Curb
Cuts:
Sidewalk Cut: Ft.
Main Condition:
Diameter: Inches ;;l (( C --f-
Material :
Depth of Cover: Ft.
Internal Lining:
,.
Joint Type:
External Prot:
"-_3
Tuberculation: NI A
External Corrosion: N/A
Special Conditions: Bedding:
Other Structures:
Minor
Localized
Severe
Extensive
Samples Taken: Pipe Section _ Coupon -I/27V"Z
Apparent Cause of Leak:
Water Off: From J.- I I r I () 0 To I r' M
From 1- IJL( I CI Z> To J-fP M
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$",tJ ~ 0 ~ /)1{ e f..-<:v-
dIJ /Jet c/c
/(0 II--e m
5/19/98
Page 1
PW-902.09