HomeMy WebLinkAbout425 E 6th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS ./
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . /
REQUEST /
Date 1-"?-.-- l' 1
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)
C(~. <) f ~+~
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J 1 t11 ctr-' ~ Phone No
Permit No
~
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Sewer Foundation Framing
Chimney Plumbing Final Sewer Excav Other
( A) ct t-ov- fl1
~
INSPECTION NOTES
Inspected
Remarks
Date
Time By
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RESTORATION REQUIRED
YES
/'
NO t./
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
~PLETE
o INCOMPLETE
o Other
/'( t ()
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
City of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No: I tj 6 ()
Reported: LI ~ f , Condition:
Repaired: L/)....1-iIi Source:
I Crew:
Emergency ~ j""tine
Citizen Complaint
Leakage Survey _ Other
7/C(
Repair Location:
Address:
Loc. Description:
t; ~ <) t:- 6 -fI,
Component Repaired:
Main Line ID#:
Main:
Joint Cir Break L
Long. Break_ Hole ~
Split Bell _
Clamp _
Other
Service: Tap _ Corp. Stop _
Line Valve: Flange Nuts, Bolts
Hydrant: Branch Valve
Other:
Pipe _
Stem
Barrel
Curb Stop _
Bonnet
Dresser /'
Other
)
Repair Type: Clamp _
Site Condition: Surface
Curb
~ Damage:
Gravel Roadway ~ Asphalt Street _
Top Soil Area ~ Soil Type _
Sidewalk
Cuts: Street Cut: Ft.
Curb Cut: Ft.
Sidewalk Cut: Ft.
Main Condition:
Diameter- Inches
Material.
Depth of Cover- Ft.
Internal Lining:
t"'\ .(
:...:....
(!-j:
t,
Joint Type:
External Prot:
Minor Severe ~./
Localized Extensive ~
0/ fAr
'tr",,'"
Tuberculation: N/ A
External Corrosion: N/ A
Special Conditions: Bedding:
Other Structures:
Samples Taken: Pi Section Coupon
pc - -
Water Off: From!LJ 9--4.. Ii f To ~ fM
From -!J J-z..i"J1. To 5.3 () M
Apparent Cause of Leak: LJ -e A... k
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5/19/98
PW-902.09