HomeMy WebLinkAboutWTR2700849 O)y mpia Ave. N.E. N. of N.E. 4th & Btwn. Monroe 1N--849
N.E. & Union N.E.
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• COST DATA AND INVENTORY
FOR UTILITIES - CITY PROZY CTS
City Project Numbers: W-_ ¢�
S
Name of Project
As required for year end statistical data for annual reports, the following information is farnishcd
regarding costs and inventory for utility inprovements installed for the above referenced project.
IO
WATER SYSTEM: �v
n
length Size Type
r T
L.F. GF -_ WATERMAIN
L.F. OF _" WA:ERMAIN H
L.F. OF WATERMAIN
L.F. OF WATERMAIN
EACH OF GATE VALVES
EA '1 GF _ GATE VALVES 0
EACH OF GATE VALVES K
SUBTOTAL
EACH OF FIRE HYDRANT ASSEMBLIES $ _
(COST OF FIRE HYDRANTS MUST BE LISTED SEPARATELY).
TOTAL COST FOR WATER SYSTEM $�
SANITARY SEWER SYSTEM:
Length Size Type
L.F. OF 15d P. ✓.G SEWER MAIN
L.F. OF _ SEWER RAIN
L.F. OF SEWER MAIN
—T— EACH OF _ DIAMETER MANHOLES
TOTAL COST FOR SANITARY SEWER SYSTEM $ 7, 74L5,
9 7
.g
0
z
STORM DRAINAGE SYSTEM: a
H
H
Length Size Type r+
H
_ L.F. OF STORM LINE M
�- L.F. OF STORM LINE 0
L.F. OF STORM LINE
L.F. OF _ STORM LINE
H
TOTAL COST FOR STORF', DRAINAGE SYSTEM $ y
.e
b
to
Submitted By.
Project Engineer
Submittal Date:
•In lieu of listing all i:tility improvements installed, itemized pay estimates or spread sheets may be
attached hereto if applicable costs and inventory are highlighted and totals are shown above on th.s form.
CITY OF RENTON WATER DEPARTMENT
Pressure y Test b Purificat'�on Test Fo.m
PROJECT NO.�/�/'[> 4'�7 pj.Q 790
NAME OF PROJECT: 014mya fw Or-
PRESSURE TEST TAKEN BY SOc I AWNA Q de' ^ON 1/IS/V6
AT A PRESSURE OF SI , FOR 3 .- NJ MINUTES
TEST ACCEPTED ON ISIP 6
PUR!FICATION TEST TAKEN BY fce AlmA(On ON 111bj $4f
PURIFICATION TEST RESULTS, SAMPLE pl 0 j0cw c no% 3 Qa e( NE ►fE.
SAMPLE k2
SAMPLE A3
PRESSURE COMPLcTE AND PURITY COMPLETE
No connections to mains or meter permits issued until above box is
checked by Inspector.
REMARKS:
•'fi' OF RENTON
A �'ERIALS ISSUED _ a 06 W
WATERWORKS UTIL.rry r
TO STOREKEEPER: -
D.Er..M.blb.iny mawial b� Mw—�=
ouANT. UNIT ACCOUNT MATERIAL UNIT
DEUVEVED NUMBER COST AMOUNT
f S
a /) v —
Abov in.bnsl r.ni..d In R../ 614d b, ANvV rd M br
fifn.d I fiynvd_ Sig
i- STATE OF WASHINOTON Dsw+aE»RHan/
DEPARTMENT OF SOCIAL AND HEALTH SERVIJES /
• WATER BACTERIOLOGICAL ANALYSIS
WCUONS ON BALK ll:OOLDENROO COPY
If instructions are not 1DIlOWed,BaflVW Will be,RIJOCtill
DATE COLLECTED TIME COLLECTED COUNTY NAME
MONTH Y YE
1 1 8� AM ❑ PM K1Nq
TYPE OF SYSTEM I IF PUBLIC SYSTEM,COMPLETE:
16. LE CLASS
PUBLIC
I.D. No. 7 ` 8 5 0 L 1 2 3 A
❑ INDIVIDUAL
nww._'i ;I..
NAME OF SYSTEM
Cny or Rcu-oll - Ulalc.. ���
SPECIFIC LOCATION WHERE SAMPLE COLIECTE SYSTEM DM4R/LIGR INME No TELEPHONE NO
kilt iow'o e�Ac�cNE 11AIG„t
C 0 fla is Aec 06 • NE 4 s► ( ) Z3y Z631
SAMPLE COLLECTED BY:INanxis
A SOF AttilwkK, if �2c3rEc ERytncf�
SOURCE TYPE
COMBI❑SURFACE ❑ WELL ❑ SPRIYO ❑ PURCHASED X or
JJp�� tsq or OTHER
$EN n¢ 4tT TTOE1Pf�Y1\F{}Rwl NA �T U1 fu X�Sosea�lr .� 7{{
r��1i'� A. F00- HILL JlleG
R ,,trl 1
WASNINGTON ♦�QSS
1 TYPE OF SAMPLE
1. ❑ DRINKING WATER ❑ Chlorinated lResiouaC_Tobal_Free)
Fi
I check treatment� ElVefed
❑ Untreated or Other
2.� RAW SOURCE WATER
3. NEW CONSTRUCTION Or FIBPRRP'
4. ❑ OTHER(Speoity)
COMPLETE IF THIS SAMPLE IS A CHECK SAMPLE
PREVIOUS I All NO_
PREVIOUS SAMPLE COLLECTION DATE
REMARKS
LABORATORY RESULTS(FOR LAB USE ONLY)
I
MP COLIFORM STD PLATE COUNT SAMPLE NOT TESTED
— BECAUSE:
MPN DILUTION • TEST UNSUITABLE ❑ Sample Too Old
XDO ml 1. ❑ Confluent Growth ❑ Not m Proper Container
I
MF COLIFORM 1
2. ❑ TNTC ❑ Insullicienl Information 1
/100 m1 ProYWed—Please Read
Instructions on Form
FECAL COLIFOR 3. ❑ Excess Debris
j ❑ MPH ❑ MFi 4 ❑ ❑
/1 DO m
i
FOR DRI ING WATER SAMPLES ONLY,THESE RESULTS ARE:
SATISFACTORY ❑ UNSATISFACTORY
SEE REVERSE SIDE OF GREEN COPY FOR FXPI.ANATION OF RESULTS
LAB NO °� TIME RECEIVED— RECEIVED BY T
j DATE REPORTED \ LABORATORY'.
REMARKS
WATER SUPPLIER COPY �x '
ENDING
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