HomeMy WebLinkAbout1703 S B St - Engineering
City of Port Angeles
Public Works Department
Water Distribution Repair Report
IWork Order No /4.3;4 "'003
I Crew 7/'5"'+ LretJ
1
DATE REPORTED 5-25" -Dc(-
CONDITION ElvlERGENCY}( ROUTINE 0 CITIZEN COWLAINT i)(
LEAKAGE SURVEY 0 OTHER 0
REP AIR LOCATION
ADDRESS 17D3 5
?? j'lvt DA.M. )t!P.M.
,
6 ~I s.*
DATE OF REPAIR.
f)-Zs- DY TI1v1E
TYPE OF MAIN
A - c... SIZE ",-,
5l f CLOSEST VALVE DEPTH.
( ,
'12..-
DEPTII OF MAIN
COWONENT REP AlRED.
MAIN JOINT 0 Crn.. BREAK 0 SPLIT BELL 0 LONG BREAK D
HOLE Pi CLAMP D OTHER
SERVICE TAP D CORP STOP D PIPE D CURB STOP D FIITING 0
METER SETTER 0 rvmTER 0
LINE VALVE FLANGE NUTS/BOL TS 0 STEM D BONNET 0
HYDRANT BRANCH D VAL VE D BARREL 0
OTHER.
COMPONENTS OF REP AIR. CLAMPj( DRESSERD OTHER
SITE CONDITION GRA VEL ~ ASPHALT 0 SIDEW 1\LK 0 CURB D
TOP SOIL AREA 0 SOIL TYPE 1J~+4..v'e...
CUTS ASPHAL T CUT _FT CURB CUT _IT SIDEW ALK _FT
DRIVEWAY CUT FT
Iv1AIN CONDfTION INTERNAL LINING ;J M TUBERCULATION-MINOR D SEVERE 0
EXTERNAL CORROSION 'LOCALIZED 0 EXTENSIVE D
CHLORlNE RESIDUAL SAMPLE ~P.P.M
WATEROFF FROM 5.3oPM,TO 7 fJ M.
FROM
M. TO
M.
Jvt4 ( yt C! Ye~ + i '"
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST
Date 5- 2~ -0 t.(
Time t/ 30 ;/11.1. Received by Derzl/tlS E ~erson)
Location of Work to be inspected I 703 S ~ ,\ D ".
Name of person requesting inspection De v1. vi t.' S
Address of person requesting inspection 6 r ;:J
I
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other M~-t~ r
E
y.c.... r d..
I it::- i-t3 Phone No
INSPECTION NOTES
Inspected Date -5 - 25> ~<j
Remarks Ke .L1c:....-oI'- C II A-c
I
Time
M-~iV\.
g 1/1/1..
0:1-"'-. 4..
By DeV/.Vl.ls 2-
5.'S -r~{( cur-de r~,;)f..'...t( ~(\.~
, .
RESTORATION REQUIRED
YES
NO X
L .... ~
t.J '77t... ST
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SURFACE RESTORATION
SURFACE TYPE D Unimproved 0 Gravel
D Repaired by City
[] Repaired by Permittee
CI No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # I c.f '3; l.{ -- DD 3>
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)