HomeMy WebLinkAboutWWP2703520TRANSMITTAL
DATE:
TO: Waste Water Utility
FROM:
SUBJECT: Submittal of Sanitary Sewer TV Tape
Project Number:
Project Name:=�R�,�
I have reviewed the TV Tape(s) for the above project and the line(s)
appear to be in acceptable condition at this time.
I have reviewed the TV Tape(s) for the above project and the line(s)
are not in acceptable condition at this dme for the following reasons:
N� ale
c/forms/ut iht'f/ww/FMSFORM.DOE;/MAB/bh
SANITARY SEWER SYSTEM LOW PRESSURE AIR TEST
PROJECT: Is- /G'
DATE: INSPECTOR:^'
PIPE
LOCATION LENGTH MATERIAL PIPE SIZE PRESSURE TEST TIME RESULT
TO FROM
I�
F
datacenter/forms/pbpw/utilitysystemshvw/sspressure.doc 02/2002 bh
M.
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Pipeline Video and Cleaning
35849 Military Rd S, Auburn, WA 98001 Video Inspection Summary
800.TV.A.PIPE 253.661.0828
PO or Job #: Date: 08/11 /09
Company: All Service Truck number: 0
Project Name: Gill Short Plat Assigned job number.
Address: 7th & Hoquiam Inspector:
City, State: Renton WA Technician: Newman
Page
Tape No.
Starting MH
Ending MH
Type
Size
Material
Direction
Cleaned
Length
1
1
MH-1
Existing
Sanitary
8"
PVC
Downstream
Yes
324.6
Summary for Gill Short Plat (1 detail record) Total footage: 324.6
Pipeline Video and Cleaning Video Inspection Report
35849 Military Rd S, Auburn, WA 98001
800.TV.A.PIPE 253.6610828
Assigned ID: PO or Job#
Client: All Service
Project Name: Gill Short Plat
Address: 7th & Hoquiam
City., Renton State: WA
Weather. cloudy Truck Number.- 0
Start Date 8/11/2009
Legal description or orientation:
Technician: Nick Newman
Inspector: - None
Starting Structure:
Depth:
N/A
Ending Structure:
Depth:
MH-1
ExistingN/A
Line Type:
Pipe Type:
Size:
Ref. BaII: Air�Test:
Air Quality:
Sanitary
PVC
8"
T 1 in N/A
N/A
-
Date: Cleaned:
8/11 /2009 Yes
Comments:
Ventilated
N/A
Mandrell: Pass:
No _ N/A
- Tape:
Footage
Position Comments Severity
Notes Photo Clip Vid Ref
0
Start of inspection - center line of structure
❑ 0:00:01
K35
.6
Service lateral left -.1
Service lateral riaht
❑
�4 110.3
Service lateral left
❑
5 113.3
i Service lateral right -
❑
6 178.6
Service lateral right -
El
7 324.6
End of inspection - center line of structure
❑
Direction:
Video Ref:
Line Length:
Downstream
0:00:01
324.6
Page 1 of 1
PROJECT REQUEST FORM
PLANNINGBUILDING/PUBLIC WORKS
DATE: J , p CONTACT: EXT.
FILE STATUS NEW OR ❑ EXISTING: FILE CODE (Plu-xx-xxxx):
LOCATION My Work Space: ❑ File Bay Shelf #: ❑ Other:
PROJECT NAME/ FILE TITLE: 14 A R-C> 1 r::::> G t V fL ev6y 16 IZ- 0 a t Ili t5f<jr45
(70 characters max)
DESCRIPTION OF PROJECT:
Za(J�l �Gt�t.t t SG
t Iv 15 : 1-tr lam ki I AAA A V9 t )6 Va rt_..
S � �-- � 'r��C !� c3T � a Z 3y S� � � 3 •.
UTILITY PERMIT # V 011 dd 3 3 LUA# WO#
ADDRESS / STREET NAME(S): 96Y X N e
DEV: ; CNTR: ; OWN: ✓ ; CNSLT/ENG:
OTHER ALIASES: 1.1 1✓ 'j e. U o`3yd 33
:�ircle Size of Waterline:
8"
10"
12"
Circle One:
New / Replace / Extension
:�ircle Size of Sewerline:
ED
10"
12"
Circle One:
New / Replace / Extension
:�ircle Size of Stormline:
12"
18"
24"
Circle One
New / Replace / Extension
CHECK EACH DISCIPLINE INVOLVED IN PROJECT
Ltr
Drwg # of sheets
TED
❑
❑
(off site improvements)
(include TESC)
❑
TRO
❑
❑
(Signalization, Channelization, Lighting)
WWP
❑
❑
(sanitary sewer main, include basin name})
❑
WTR
❑
❑
(Mains, Valves, Hydrants)
(inc. composite & HorizontalCtrl)
x
SWP
(CIP only)(include basin name)
PLR
(For Developer Files Only)
❑ (letter only)
E CIRCLE THE DISCIPLINES WINCH NEED TO SIGN 1MYLARS
WATER WASTEWA)IR SURFACE WATER TRANSPORTATION FIRE
FOR FrLE MAINTAINANCE USE ONLY
File Codes
File Alias
Date Entered and Labels Made
'
G' —C: 'l
rl 1/L/
BILL OF SAEETT�jNaxrk:
6;11t-scwe-'� - '.,:' Pro perty Tay Parcel Nwnber:
<o4 .
11'rojeclFileN: PL9 A;-V��bS *cctiQ6. A dd re � s: S'0 o j �-o c
tree.tlntcr
Q r
Reference Number(s) of Docurneiiis assigned Qi rel�ased: Ad0kional refercipce numt�rs gie an page
Grantor(s): �rAutee(s):
1. y f !Oi�qn, a Municipal Corporation
1. 14CA1,61.? Ci� �
2.
The Grantor, as named above, for, and in consiticraii6n of-mut4l benefits, hexi bv gi - anW't�ar'�� - i'fts,.sells and dolivers to the
4
Grantee. as naincid.above. the following described personai.,.Propeh*
Y:
WATER SYSTEM: Lcngt T
L.F. of Watei Maiii
.7
L.F. of
L.F. of W*cr Main
each of Valves
each of
each of Fire Hydrant Assemblic
SANITARV"S"EWE R".8';YSTElK: lon2th Size T
3 P, Z. IR
0 L.F. of Sewer Main
L.F. of Sewer Main
"-'.I,.F.
of Sewer Main
6kich of Diameter Manholes
C�ch qf.�. Diameter Manholes
;:I..,:eacho Lill Stations
f
STORM DRAINAGE SYSTEM:: Length iys—e
-F. of —32- C E ik P Storm Main
L.F. of Stonn Main
Storm Main
eacli�of Storm Inlet/Outlet
3V
each ol Storm Catch Basin
Manhole
,Wall.C'Asphalt Nvemdnt):!
STREET IMPROVMENTS: Oncluding Curb, Gutter, Side
Curb, Gutter, Sidewalk L.F.
Asphalt Pavement: SY or Width
141: F. oi
STREET LIGHTING:
# of Poles
By this convoyance. Ortuitor will warnuit and defend the 4tale licreby madL untotheGraniec again%t all and every roorsag or perions,
whontsoever. lawfully claiming or to claim the same. Ibis cotiveyance shall bind the hcirs, cnectitors. atiniiit-istrator-,.uidkssigtLs I 'or , ever,:.:
0AFonnskPBPVAHiLLSALF2.DMkbh
AN WITNESS WHEREOF, said Grantor has caused this instrument to be executed dus day of 20c-�
A,
[A"DIVIDUAL FOP,&I 0FACKA'0*'1.FDGA1FAT
:::'Notiiry Seal must be within-b?x STATE OF WASFUNGTON SS
COUNTY•< )F KING
car`tifv that'I know or have satisfactory evidence that
A en
'01A 44, . . signed this instrunicnt and
-v...ackno,�'I,,ed. it to bQ. his/her/their free for the
X V*: S& and voluntary act uses and purposes
-ent M holl f r
0 the u
(P Z A
i7py" T —Notary-'PiAjiQ': in A State 'of hin
a 19. or ton
-Notary (Print):
11111WAS .:
My:appointment expipes*: i
D
RFARF.VFA-TA TIVE FORM QFACA-N0H-'LE.DGV11-,A'T
Notary Seal must be within box STATE OF WA41=M4GTwi S'::
:5 S
COUNTY ORKING.
I certify that I knowq�r ha4s'kisfactory evid6 . nce,ihat
thig instrtiment, ign. on oath
I'L-re.'auth stated that he/shelthey i re...'auth z ..10 exviiGtrtlte instrurnent and
acknowledged it as the And
of lobe Ike fret~ and .Vol untory A -et of.,siuch
party/parties for the uses and purposes mcnftonedf'frr'l ic instiumprit.
........ . .
"-:..Notary Public in and for the State of Washingtbn.-:*
Notary (Print)
My appointment expires'.
Dated:'
CfIR110. F. FORMOFACKNOWLEDGMEAT
Notary . bm Seal must e-*-within box 9-TATj ` Fi'. A91AING-TON SS
n this d# of.:-' -20 before me personally appeared
to me known to
he of the corporation that
e 1h, within i—nstru.Oient,,.ind,#ckiiol4�dge..thc said instrument to be the free
and voluntary.:act aria..4ecd ofs�aid dorporat ! ion, foi - 'the uses and purposes therein
mentioned, and each on oath stated thatti0she Was atiffibrized to execute said
instrument and:*to.Iliq'seal :Affix ,W is tiro coiporate seal of said corporation.
Notary Public in and fbr,-the,Stato'of Wasbingtoa,:`
Notary (Print)
My appointment expires:
Dated:
........ .. .
0AFormsXPBPM8IIASALE2.D0CXbh ..:Page