HomeMy WebLinkAboutWTR2702165(1) W-2165 Fred Meyer 2
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AUTHORIZATION OF SPECIAL BILLING
DATE: AUG.23, 1990 II
PROJECT NAME: FRED MEYER RAINIER AVE S.
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PROJECT NUMBER: PERI111T NC940122 4
WORK ORDER No.: 87585
It is the intent of this letter to authorize the City of Renton to bill the undersigned for all
costs incurred relative to the referenced project,by the City of Renton for the following
work
TIME AND MATERIALS FURNISHED BY CITY OF RENTON WATER
DEPARTMENT TO PERFORM CONNECTIONS TO EXISTING WATER
MAINS,WATER PURITY SAMPLES,AND RELATED WORK.
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1, TIME AND MATERIALS FOR ANY AND ALL ROAD CLEANUP EFFORTS
PERFORMFD BY CITY FORCES OR CITY CONTRACT.
ALL OVERTIME FOR INSPECTION AND RELATED ACTIVITIES,BILLABLE
AT A RATE OF FIFTY DOLLARS($50.00)AN HOUR.
TIME AND MATERIAL FOR ANY WORK DONE BY CITY STAFF TO REPAIR I'
DAMAGES.
BILLING TO BE SENT TO: ))
Name: Fvet> r1c"/EfZ\tL1C _ gT7l\ '• v�tt� B�al'>✓'>�
Company'
Address. Fts 6cv.; vz t t I
fk,2T�n,.tp �6(7- Ot tLHL
Phone
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Owner/Developer or Authorized Agent
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CITY OF RENTON
MEMORANDUM
DATE: December 29, 1994
TO: Becky S.
Ray Sled r
FROM: Arneta x6198 AA
SUBJECT: FRED MEYER ON RAINIER FEES THAT HAVE BEEN PAID
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P90JECT WOx : 87585
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PERMIT: C940122
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COPY OF LETTER OF SPECIAL BILLING ATTACHED
WORK PAID FOR & AMOUNT: $3,800.00 FOR CONNECTIONS & CUT & CAP
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' CITY OF RENTON Constfuction Permit
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Permit Number C940122
Permission is hereby given to do the following described work,
according to the conditions hereon and according to the approved
plans and specifications pertaining thereto, subject to compliance
with the Ordinances of the City of Renton.
Work Description
INSTALL APPROVED PLANS #2165 WATER, SEWER STORM ST f,O:�`p M% V�,F
ALL PER APPROVED CITY PLANS
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Job Address
365 RENTON CENTER WY SW
Owner
ROUNDUP CVI'IPANY
3800 SE 22ND AVE
PORTLAND OR
97202
Contractor
LEE, DAVID Contractor's License
Contractor's Phone 206-336-5751
City License LEONARD BOUDINOT 6 SKOD
Contact CRACKER, ED Cor.- .i's Phone 503-685-7350
Other Information
Dale Issued 11/22/1994 Work Order 87585
Date of Expiration 05/21/1995 Parcel Number
Date Finaled Inspector's Name WETHERBEE, MARK
Inspector's Phone 999-1829
It is understood that the City of Renton shall be held harmless of any and all liability, damage or injury
arising from the performance of the work described above. You will to billed time and material for any Work
done by City staff to repair damages. Any work performed within the right-of-way must be done by a
licensed, banded contractor. Call 277-5570 one working day in advntce for inspections.
Locate utilities before excagling.
Call before you dig - 48 Hour Locators 1-800-424-5555
1 hereby certify rhat no work is to be done except Subject to compliance with the Ordinances of the
as described above and in approved plans, and that City of Renton and information filed herewith this
all work is to conform to Renton codes and permit is granted.
ordinances.
Applicant > Public Works Rep
THIS PERMIT MUST BE POSTED AT THE JOB SITE AT ALL TIMES.
1103203,08/94 if
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�9 CITY OF RENTON
Plat Inspection Record
,
Permit Nua.ber C940122
Address: 365 RENTON CENTER WY SW
Date Issued: 11/22/1994
Date Expired 05/21/1995
Work Description: Work Order: 87585
INSTALL APPROVED PLANS 02165 WATER, SEWER STORM ST
ALL PER APPROVED CITY PLANS F.t.r� �YJE YE�E
Contractor:
LEE, DAVID
HATER: SANSTARY BENER: 4..
Pressure Test: _ Pressure Test:
Chlorination.-
MH Channeled:
Pur t Test: MH Sealed:
Tie-In by City: Side Sewer Visual:
OK for Meters: Pressure Tast (SS) :
Valve Chambers to Grade: Maintenance Walk-thru:
Maintenance walk-thru
BTORN 9EMEA7 RIGHT OF MAY:
MH Sealed: Curb i Gutter, Driveway or
Sidewalk:
MH Ladders Sight PreDaration.
Visual F na : Final visual:
Mn ntenance Nalk-thru: Maintenance Wa k-thru:
AOADIrAY2 BTREET LIGHT OR BIGNA
Coct on Test: Foundat ons•
FIRE! L It or Patch: Concrete Pads:
maintenance Walk-thru: W r n :
Controller Cabinet:
Overhead Sns-ec�t
Final Visual:
NOTAe:
A88IONED INBPBCTOAi IDATE OF FINAL ACCEPTANCIi
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CITY OF RENTON
DEVELOPMENT SERVICES DIVISION
AUTHORIZATION FOR SPECIAL BILLING
Date: _ Z e — >Pep y
Project:
Permit No.: Type of Inspection: .. FLcci -
Work Order No.: Inspector: 1p1 +dc 1D .64r irveiL
Datelsl work Scheduled: /y -I ye
+ It is the intent of this letter to authorize the City of Renton to bill the undersigned
for actual costs incurred relative to the above referenced project by the City of
Renton at the rate of $75 per hour. Certain other conditions apply:
Weeknights: A minimum one hour will be charged.
Wee en¢s� The City discourages weekand overtime work. However, under
certain unavoidable instances, weekend work will be authorized with a
minimum two (2) hour portal-to-portal charge from the inspectors residence.
Partial hours will be prorated to the nearest quarter hour at $18.75 per 15
minute increment.
Holidays: Some as weekends with the exception: Four (4) hour portal-to-
portal minimum charge.
Authorization by the Building Official must be obtained prior to performing any
requested over ti tion.
AUTHORIZED BY DATE:
r a a Toet etxLONe genetAL
BILLING SENT TO:
NAME: rKvNso FSewc
ADDRESS: /3/S iV. sty /ss/C// S'_
CITY,STATE,ZIP: i�;54 4f-d4. 060e7
ATTN.: k- li,^ti /y, "ll
PHONE: 507/" ZrZ 3P
It is understood and agreed that owneddeveloper agrees to pay for the requested ovenim as
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REQUEST FOR PROJECT M Prchm.Plat (PPM )
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From. plan Rcwcw/Ptpjat Managcr
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Projon Name
(10 tlwaasr w)
Deacnptron of Project:
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Circle Srre of Watcdine 8" 10" 12' r r —
�(o Circle One or Extension
Circe Sin of Sewedine: 8. 0 12" Circe Om e. � or Extension ]
Circk Sire of Stomdm: V 15" 18" 24" Circle One: /Neely. or Extension
Address or Street NartK(s)
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INVOICE Renton ttr Drt.t REMIT Lauhs TWI M1 LaOoratorlts
TO 3555 M.E. 2rld Street �IIAI( M 4.S 10 040 Swth MAr'nev Stroat
Renton. IAA WOSR �� Seattle. W "m
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CITY OF RENICN(WATER `r... . _
' •ulaDie_ No
3555 NE 2ND 51
RENTON WA 980564192
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CITY OF RENTON '2(E(E]7 - _ A5Ar
BILL WALKER ,. N
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FRED MEYER PROJECT
p � (B20132) ROMAC 202 BODY ONLY I ^ten
4.00 err PULLED UP ++ (M35400) 1
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0` 6.00 IM�MN NNNN S (B940924D O8" X 24" 9408 VALVE BOX 1 40.31 Pula Tho Follow
AS p I (ASSMBU WATER, DOMESTIC, COMPLETE a ec
6.00 1 ** PULLED JP ++ (M35400) 1
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AS P I (51004) USING - 40' C0I65
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160.00 ++ PULLED UP +* (M35400)
JA TTS7S Q" S.E. GATE VALVE I SB.60 I 1 0
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OSE 30m.9ELLENIE WAW%5.12961�e66tC0 122 'r AVE EAST.5MMNE4.WA%390.12061863%00 1
MIDWAY LANE-INEILINGHAM WA 98226•i0061?Ja M60 I4r7WEST J STREET•VANIMA wA98902•,S091248M00
1STATE HW13•DREME.PTON WAN812•,M1377A50, 52605 W ALGER•BEAVERTGR OR 97005.15 lTI -2
MARVIN ROAD NE•CLVVPIA WA 98516.12061.07300 r4325E 102m-CLAC8 A5 OR91015.15031656d
1� Maio 4/✓1/95 16355: 18 Pv'
-ATTENTION SHIPPING+ Fa9e vn
CITY OF RENTON/WATER P"y
d�er Dere w.men nn6 7atWE - . J�9
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2165 MIDWAY LANE•BELLINGHAM WA 96226 2061 FM MW 1019 MST J STREET•VAKIMA WA 96W2.135912.8 MOV
`ASN STATE NWT 3•BREMENTCN WA9012-,013774W7 SEWSW AAGEH•SEAVERTON.OR92W5•IWA6ffi24W
W1I MARVIN ROAD HE -OLYMPA,WA 96516.12061 457 156325 E I O2Ie CLACKAMAS OR Bn 15.1W3165629M
4/'21/95 1.6:55: i9 P: Lr.:
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CITY.OF RENTON/WATER
3555 NF 2N0 ST �• i ^
RENTON WA 980564197
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CITY OF RENTON -__-__ ASP
BILL WALKER 'K.
1000.1235-26a
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iIDESCRINION UNIT MICE
40c Joint Accsssc*y Kit Summary For Iron Fittings
14.00 = -_-_ FI3 �" SET OF MJ ACCESSORIES r INC
�.00 A FY5 I211 SET OF MJ ACCESSORIES - iwt
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PL 4 tNN'ING/BUB.DING/PUBLIC WORKS DEPARTMEI T17
Water Utility Engineering 2352631
'��'N•rp� Municipal Building 200 Mill Ave.S.Renton,WA 98055
BAQQI.OW DEVICE TEST REPORT
Uwq wuaa At..euet No. C.ouu+Pnwo fmun PEwe
N..c W Penile s
s=.w.e eem7(off
I
Inntlae MDnla.
L
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Iffi the lL M T-FJ
R forme Fi 1ReracDae sruem ❑ IntWM. ❑ otiw if =.Pk—W-2r
Rtft�P Anntsbs Ptctwrt V.vuu But=
Deabe t2aVt A..Mb Akioki t2etltvme
I�Oeak aed meek Retet VJ.c opc a _—pm
lw i Ta DC4ti d tieb-... OaM Ulhc.. Did eat^Pu ❑ Idcd ❑
_W/d&Pdd Inked
Inktd ❑
N.tenale
U.d
Ta AM1v DC4.cd USb-...❑ OaN dg ... ❑ oPmcd u opted u —pdd
Rery4 aM_P� —P&I —pad
Air Gap Inspection: Required minimum air gap separation provided V4. ❑o0
Remarks: -.
IIIE ABOK 111?ORT Y lFJn1P®TD a!T11UE
Return Report to oR pRBVIFn N Phaoa Nuuhe
Tom Malphrus,Cross 2A 9-'ZAo
_ Connection Control Specialist mnT 1 BY, Cm W Datc
PUnning/BuildinW
Public Works Department RVAIRm By c<a na. o.ta
Water Utility Division
i 200 Mill Avenue South By., , � Cw w D.ta
Renton,Washington 98055
Crowwkmr/Atx Wihh
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PLANNING/BU1I.DING/PUBUC WORKS DEPARTMENT
Warn Utility Engineering 235-2631
Municipal Building 200 Mtil Ave S.Renton,WA 98055
RACMOW DEVICE TEST REPORT
Uua7 RWbaKrouot�N. �J�/ Coelud�oR �4 PkWe
Scnke Addrtv
babe ornedce
• NaeWunurtr Node) Sky Se.vl o.
�r vA ���,s Lr5 �••,r
ILenvurt urineafrew �D u0 lkr lew+IWbc/.'ut..Tat..7 opals—oa-u
Rauoe b Deeke rue rwea+ba Syp O ��j.u� o olker no�ker, eveeur
acdw...d Prmwc Areeddb prtwrt veeN.m tYolcer
Ila�ble Che AuembRw Ake Deck YY.e •, d..
Iw CReck aed Caed Reaerr opined" —pdd
_Pdd
u Dld Ru opce O L.I d 0
WW1Tew DCidoeed URNc... Oiled UakL.. �d
RP._plid reeked —POW
tdwd O
Rep a ud
W.ed.k
Urd
Tea Mee becloud UpkL...O ctm uk4.. 0 opeeedu opme —pdd
Rcpur RP_Ped --Pod —p"d
Air Gap Inspection: Requvcd minimum air gap separation provided O w O m
Remarks:
Tta ABOVE REPORT 5 CNE W®To se MUR
Return Report to m C1R PRINTED
NANE: Pkoue N"ate`
Tom Malphrus,Goss — A&L
Connection Control Specialist INmAL TEST BY: cen N. Due
Planning/Budding/
Public Works Department REPAIR®W e N. D"e
Water Utility Division -
200 Mill Avenue South r Rr: /_ Ccn Ne Dwe
Renton,Washington 98055
GroRMSM1.CRACT.ML0W/"
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I
ti`tY O
p1A-NNWG/BURDING/PUBUC WORKS DEPARTMENT
+_ Water Utility Engineering 235-2631
Municipal Building 200 MAI Ave.S.Renton, WA 98055
BACKFLOW DEVICE TEST REPORT
Ud11�swin6 Atte.nt No. Cm//un it�m/J (:o.un flme
sa�In Aaatea 3 rp s Q 1 �/
Id.p.(nurtr Nodet
sue
u.e n«.tt..tTme dTmt ,t� N� M 0.
(J UIs st. ' 5—00 3 a'
R.t«tx+k Fxe Pn t--�m s1+�® O InWt^^ 0 OW usher.P� -P�h
if Se( E o/e4e
0.e6u�N ttv..+n AacmEun Putt Vurum&okra
DoeEk�Xek Avembkm Ak 1.M cs tl Va .
1s metk a.d meet xdkfv.Ne ppmcdu �PLd
t.a
IutW Tot DGd«ed trW.... Coo dales• oR•du Dana.P. O leaked O
RP'—PAd idml �_P.a
t..krd O
RCPWa
N.tedau
Uud
TU Mo Dr.eln.d tyx...0 O«ed tale.. 0 OPmedu Oped mu _PW
R"k RP_P• _�pdd P•a
Air Gap Inspection: Required minimum air gap separation provided O rm 0.
Remarks:
Tim Allow ami r u carmen To M TRM
Return Repoti to OR Pxi�` NAIQ. P Nu
Tom Malphtus,Cross //w /�'/,sa+SN/Q A2 A -32/5� _
Connection Control Specialist Um Tur RY. ee.t N.. D.e
t PlannikWBuilding/
Public Works Depanmem REPADtm RYA utt N.. Due
Water Utility Division
200 Mill Avenue South a een Ne. Due
Renton,Washington 98055
CMRNSMISUMCIMOVD h
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PIANNING/BUBDING/PUBllC WORKS DEPARTMENT
Water Utility Engineering 235-2631
�N Municipal Building 200 Mfll Ave.S.Renton,WA 98055
BACKFI.OW DEVICE TEST REPORT
UW1ty Acco t No. Conurt Paco t<em Fkoor
rLue dFlevse �-
iG
re.iR Am.
2ln
/��CcA'iut.a/ �ae-h .7•�/�sV.t_L�f..�/lK.rb✓SC `-e
G � Modcl � 61s_ SYW Nw
�Pleruc rTlmedTer � Nerimrtlr: •i 7m O se a
18S -0U
R.rar lk.ke Fke Plalca+loe S.. O II.Wum O odr. it .vlme.petlry ....,�.4
'L^rST...PtirS .v r
Reduttd Plenue AaemWln Prue Vann■Yoke
Da r3c4 Ar®RYe "b" [beckva.
In ch d a.d Che Re&t Vaee oppW■ -Pm
idWlra DCcb.cd tigke.., ci. u�.. upeeeau dd mluPn O tm�a O
Raf�ra pw t.e.kN Y•O pu t
IsakN O
It p.k..ed
MredJY
1�
Ter ARa DC.I.W V&U 0 a1 dUOe.. O opc Opeaedr _Pld
Rep.k RP._pAd -Pw _pw t.
Air Gap Inspection: Required minimum air gap separation provided Ore 0.
Remarks:
rere ARovR RRroRr o®rm>m To RRTRt2
Return Report to oa ni NAr¢ phoee Nlwker
Tom Malphrus,Cross - O
Connection Control Specialist u4rnAL Tern BY een No. Due
Phnning/BullduW
Public Works Department m,"' m Cm N.. Der
Water Utility Division
200 MW Avenue South a r:lY No. r T}.sT - ..
Renton,Washington 98055 - S
GF0RMLMSC/0ACM0Wft
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e . PLINNINGBUB.DING/PUBUC WORKS DEPARTMENT
Water UNllty Engineering 235-263 t
Municipal Building 200 Mill Ave.S.Renton,WA 9055
RACKFLOW DEVICE TEST REPORT
Uu q BRBog Accowt No. eootact Petaoa ..
rcotul rRdoe 77 •.
Name d P>emkn
Sentce Addeeu Y /+
t�Um of nevlee
yA�qg�yg�Ar� �� pq�mmm ��t �i
./ f3sSg �L✓.�lTg', MOM
y',e setW Ha :.
U t'�`r k
flue hmat<uttme ofTm Newtuuatktlou: Om 4 .
Refoo fa nettce tie tvoknbn sin® Q Uuo Q /�
omv amber,Pkau aP-4
C.
Reduced Prcanue Ae+®me Prc va ateker
Dwbk meek AaasmbBe AR Wet mock vatae
to CRcc4 add Cb k RdWVa npeeNu _Puy .
__Pay
twud TM DCCN agyt,,,. Ckad M wMt Wae.. O o au a m Q aeetap tma Q
_�Y Pay
tanked Q
RepWa ud
MYetiLLr
Uacd
Ta Me nCtloaad tyltt...Q Cloud tine.. Q O!>mW u apeyed n �.
Repa4 M�Pw --Pay _—pey
"GaP Inspection: Required minimum air gap xpanUon provided 'F t`a Q„
Remelts: ....>�,
TPa ARovR RRTORI'u t3AfIFtID TD k rnue
Return Report to TRW Dg r�N�
Tom Malphtus,Cross fsry S,yi eZo?8= 'j�2 d c/
Connection Control Specialist tNZd C ar: w No ate
Planning/Building/
Public Works Department REPAIRED BY: c< a1C
Water Utility Division
200 Mill Avenue South gv;
Renton,Washington 98055e_r5--
C:PDRMS,M"WUCXROWi h '
J
♦ ♦ PLANNING/BUILDING/PUBllC WORKS DEPARTMENT
Water Utility Engineering 235-2631
Municipal Building 200 Mill Ave.S.Renton,WA 98055
BAL EFLOW DEWCE TEST REPORT
VUJrI Bulks A.[N�. Codtae hnm fmuce Pbme
Name dPtemlam �
f -7��/�/�
sa.la<Add�m3 6s �S.N rn�.! GatL�/TrR !✓�/-�/ Jam✓
7M,
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A vA ufac�me 7 Mae No.
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iJx MItMRe M b.dTen > ^_ Ne W sMan. r. O m
_ I8S
1.On Deake F Erotecum Sratm 0 I`nw R 0 Disc //��t``k�''Fr�� R.bet.pka.apedry
/roi57`VC V Y SJT�+�
n
Raduced fhomm Aaaetvbll. pvwe Vaeum d.km
Doabk meek AutmbBea An IOM coed[Va
In Cbeck rdE CElck ltdw Vdee Opt n _pd
_pd
Ioltil Teat occlmed ughT. Ckaed ughe.. opmt.Y DM m aspen O Laked 0
M_paid IsakM —pdd
I.-W Cl
RepMn and
Mucttab
Used
rot Mer DGticud light_0 Ckaed tyl _ 0 opmd u Opened u —Ind
Reek RP-—pad _pd _ —pad
Air Gap Inspection: Required minimum air gap separation provided O n Ow ,r
Remarks:
—_ nx ABOVE REPORT 6 CEll71311t[I iO BE nut
Return Report to oR PRIPCIM NAME Fbme Number:
Tom Malphrus,Cross AI - ' �20 e
Connection Control Specialist BVrnAL=BY: sera Nn. du
Planning/Building/
Public Works Department RPPAdbD BY: sera Nu. Date
Water Utility Division
200 Mill Avenue South BY: teas N. Date _
Rmton,Washington 98055
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6• �' PLANNING/BUBDING/PUBUC WORKS DEPARTMENT
se "
Water Utility Engineering 235-2631
Municipal Building 200 Mid Ave.S.Renton,WA 98055
BACKPLOW DEVICE TEST REPORT
Ut ty Mmng Ac unt No. Coouul Pnfon Cogt>1 Phanc
Name of Frcmin I #i�:
�a4��ycnn
Service Addtt. A
R.n Nodel sin I ( gvial No. :.-;-
T / 0t2
une No.ue u'nme N'('_� Ne.rmW.wn: O tw
Reeeoo ror De.ce Phe lhaeNm sy. 0 ketion�0 of zKvote..P a wee*
RcducN Ptvmte A..mn Ptrantte vaeuttm Rtvem
tlWbte medcA.emblw A4 Wet ch.*vhe
t.taeex ma Cb«k Reaervute 0'u . _P.d
Pdd
WUUTt DCcqraeed ugnt....� 2-e ght_' t Did not opm 0 LtWool 0
^'Ot-.�P+d bleed 0JCsliwd
bled (3
Repute
N.edW
fYcd i'
Tm Aft. Dod.eddghL...O c7 ugW.. O Opened. opensd. —Mid
Repur MP,_pdd —PW pdd
Air Gap Inspection: Required minimum air gap separation provided qya 000
Remarks:
Lse ARove RvoRx n�xtu®ro ee rntre
Return Report t0 t��Rrryyy P NAME:'.�m Malphrus,Cross tH � l-3�Connection Control Specialist =R . Ccd NoPlarmLtg/Building/Pubde Works Department A . CmNo.Water Utility Division200 Mid Avenue South B , t Cm No. D.e
Renton,Washington 98055
C:PORNS,RAI.SrlaA03L0W/hh
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• • PLANNINGBUILDING/PUBLIC WORKS DEPARTMENT
Water Utility Enginechng 235-2631
Municipal Building 200 Mill Ave.S.Renton,WA 98055
BACKFLOW DEVICE TEST REPORT
IARAy IMIp Am..No Cwsee.Pea Casr PMO
� S—
Nasd11a1� SEATTLE BEST COFFIN-,' —
s..ift Aria 365 Renton Center Way ,t•,� Renton, WA 98055
EO4�O'afO�I' In cabinet under sink. (For car—bevy achine)
Ally mwm11m ft M.M Sift SOW Na
RITA Wilkins 975 3/4" 301252
W Plseasr TEN dTa TTPsdArsOvYy --
"73 � RPRA
PLEASE UPDATE THE ABOVE INFORMATION AS REWRED
Aeduosl Maus ArenlNa Plaus V.Budft
Daale Cllor Aftvnblr Ai Wr f]Oi VYW
IaC T+r ONdl ReidvJ gpOdr_ _Md
i, pid
adliW Ts, DpppC(CC`,-���'daaa-Nd�.'dduall.,T� Coed l,o QI omw A Did ml ONn (7 W w
Irw 0
ROsds
MOrisY Ulsll
TS Mr nCdoad YdA...O CIad NFla opNNda Ope�1Y_ _
Pd
Rpr RF_Is0 pd P d
Air Gap Inspection: Required minimum air gap separation Provided C1>y O IN
New Installation: O
Him
Remark—
, W.NrSpcNIINe co. , 1
"..I Ssr.N.rsnlpcalnmllrn
Dona NF
NIANM,W.NNpI(M MlU
M IAl1 ll]JiM
THE Above REPORT MCERTIPIP.D TO BE TRUE
Oyu TIVITEDev Dick Unger W D. 10-20-95
Return Report to
Mike Dotsm Cnm T-1 s (206) 827-4964
Connection Control Specialist (Plftft rtsrl.agydRsrasl Rr aquipnels alA.rmaunw,al
Planning/Building/ RtPAIRED BY D.le
Public Works Department
Water Utility Division MAL TEST BY Da
200 Mill Avenue South
Renton,Washington 98055 CERTIFICATION NO'ORIRATION DATE:
1912
c IORM&NlJa ACRTI.OV.'AA
,n
I
j PLANNING/BUILDING/PUBUC WORKS DEPARTMENT
Water Utility Engineering 235-2631
Municipal Building 200 MiB Ave.S.Renton,WA 98055
BACICFLOW DEVICE TEST REPORT
UUBry BI 9Account No. CooucgPcnan Cuouc�Pbooc
Nuoc ofR®bn /' � A// yi n
l�J SNTLVv CS.�Ir
ip340Y DeMce
uoc P.vauc ullmc afTm / N4LVYBa11on: ro 0 . F
O�{(Eu
R.for Duke p4c eiwccuon syaem 0;C S�"O/�'IR?�' \ u a�bcr.Pi sK sxdtr
RMueN Prtv�ue A bUo vacuum Rmk
Doubk Gen Aum b. A4lydn m V.he
to yen and Check Rebe(Vahe Opened u __paid
,W
In....:Teu DCclmed UghL... C o"Ugh ,. Opened n DM oo.open 0 Leked 0
RP_PUd tekcd C) -p61d
L.Red O
Rcpain nd
Muc.ials
Uud
Ta Mer D 1d Ughe.- O U d tighe.. O Opacd n Opened.,
Repair RP._pud
Pud
Air Gap Inspection: Required minimum air gap separation provided O ye. Ono
Remarks:
THE AeovE RepowT is Q.RTIP4D To eB rguB
Retum Report to ED OR P N
Tom Malphrus,Cross /}n% n/SH/��
Connection Control Spcciadst DaTL&L TEST BY: ccn No. Dau
Planning/Budding/
Public Works Department REPAnuv BY: een Nn Due
Water Utility Division
200 Mid Avenue South F. BY. C No one
Renton,Washington 98055
Yr
c.PORMS/MISC/BAcg V/hh _.__,
F
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BACKFLOW PREVENTION ASSEMBLY TEST RE RT
_ ReturnNo Later Than:
Name of Premises: Flop f'1��731� MA/)J��n� File No.:
ServiceAddress.34 Rdm p 1649,
Location of Assembly: WO!�7s/DEOF .I344P l^( GfiNiF-P pF 1 v ALL
Assembly:_ 911 Z' -
Marwlacrurer ModM L_ $tee Senalw r ris
n
Line Pressure at Time of Test _y��
LBS. Type o.r Assembly: C; ,
tiReduud Pressure Assemblies Pressure Vacuum ereaker C.
Double Cheek Assemblies RNId Air Intel Cheek Volvo 16,
tat Check
2nd Cheek Opened at
Volvo _ —plod
kkeyyy _ps-d
DC-closed light Closed light Opened at Did not Leaked .. 5
Leaked
'Initial Test RP,_paid Leaked
Ps,tl open Q.
k
RepaaS
t
and
Materials JUL 13 tyc_
Used
p
Test Me
DC-closed tight Dclosed UpM __.. Opened at Opened a;— —os,d
Repair RP.__ paid
Air Gap Inspection Required minimum air gap separation provided c
__.......Ves ❑ No
Remarks _
The Above Report is Cent
Initial Test Performed By: y �� Cen. No-B"// tell
Repaired By: {�ale:
Final Test Performed By: Can.No.:
te:
Water Service Restored Yes No❑ _
Cusli Srgnerure
I P;=
(A- 7)
Massive_-_ .
BACKFLOW PREVENTION ASSEMBLY TEST REPORT
Return No Later Than:
Name of Premises: F� RaR HAF VQ/Z 141'RIAI /3GD, File No.:
Service Address: RA/N/�iZ 091/401 moo. RPNloA {y19,
Location of Assembly:l✓fV-S/Ajr p7 D/,O. /,y&�4T ��y jZ oFQ�Ih/NNIS�.JAtL
Assembly:_rn/dza 019 1Z7a9
Manufacturer Model Sve Sena'No
Line Pressure at Time of Test: _ LBS. Type of Assembly: DG_
Reduced Pressure Assemblies Pressure Vacuum Weaker
Double Check Assemblies Rellel At, Inlet_ Check Volvo
tat Cheek 2nd Chock Valve Opened at _pyd
Paid
DC<bsed tight Closed tight Opened at 2d not -. ❑
P- Leaked
Initial Test RP-_psitl Leaked _Ps:tl open
Leaked ___. ❑
Reparts
and
Materials -
Used
Test Aher OCUosetl dgM .....❑ Closetl tight ❑ Opened at Opened at petl I 4
Repair RP._paid paid pert
Air Gap Inspection: Required minimum air gap separation provided ...........Yes ❑ No❑
Remarks:
The Above Report Is Cerldie Be Tr
Initial Test Performed 8y: Cert.No. Date:
l 2�93
F'
Repaired By: An
Final Test Performed By: Cart.No.: te;
Water Service Restored Yes No❑
Custornsr's Sgnature
i �
i (A_7)
PLANNING/BUILDING/PUBUC WORKS DEPARTMENT
Water Utility Enginacring 235-2631
Municipal Building 200 Mill Ave.S.Renton,WA 98055
BACKFLOW DEATCE TM REPORT
Um"Rift Accmn�No. Coned Perm Cooua Phox
se.l«,wamo .3�5 G�c„�rv.J C9-,r�trc G✓sr �/ --
Wade.doev{ce
tA.e Pawn<arlme ofTvt .�� I85 nevi�aaabo: � Om
Raaara De.la FePmenlmsyn O IMpYm O oUxr it otlae,Pt -pmvy
F v/ C'/¢S
ReducN Prerae Avemtta F'. v.meatawter
Dontk Cted Av®tlMa At lolel ceecA vas
S
lmm rnd Clerk Rellay.he ope 4 —P•
_Pad
Inal.l Teal tlCcl..ed UEM.... C Ogle... Opeoeda Did sa opm O fated O
a —mm l.ated _Ptt
L"w O
kpw add
U.I.i11.
teed
. Ta.Asa O(:da.ed Uwe....0 sacs Usti... O opa"a Om"a —_P•b
aePs a —pm —PW —Pb
Air Gap Inspection: Required minimum W gap separation provided Oyu O m
Remarks: '..r
q '
,t.
THE ABOVE EXPORT I5®n1P®TO QTn W
Return R.•port to t+Asre Ptone NUmta
oa
Tom Malphrus,Cross .F.v O
Connection Control Specialist s+nuLTrsr",. Cm No. D.te
PlanningMudding/
Public Works Department ]UPAn®BY: Cm ml Oft
Water Utility Division
200 M01 Avenue South TQI'urc Cm Mo. Dae
Rental,Washington 98055 aw
C:POasuanos45nctut-OwAh
-
PIANNING/BUILDING/PUBUC WORKS DEPARTMEW
Water Utility Engineering 235-2631
Municipal Building 200 MID Ave.S.Renton,WA 9W55
BA(]Cn DW DEVICE TEST REPORT
ndary BRBeg Aem�mt No. runner Paaon Coeur Phone
Name MP�bn `�- 4 A y
sea�lcc Addnm l� s /,CS../Yoi.J LCNTi R (N�t- S 4
luaean M Dcac
gR4'b,.S FRFG�tlL oVeVA f7Sy dO407
hdaaattfa� M."
LIf ITS ePO'>Qv �YA, D 1 l 3
irnc Nenut"T MTen 7S NeeetaaauNoa: m OCO
IBS
ft..w ra Deekt O O oDr: uatha,pm+e apedP/
FCE Mif a�-t./�
ticdeced Pivme AvembBm Pnawe vacvm Bute:
Doehte meet naemwe A4lolet CtCet Vane
Ix and CBeet Re cf v.he opeoec at __Pw i
Wd
weal rea t>utmed ught... amee ugnt.. opcned.� Dw ear epee O iakN O ,
RP_pId Inked _paid 3
ta. d O
Repata and y
Atatctiah
4N
Ted Mcr DCelovd tight..O Closed fight.. O Op nm at opn u -Pad
RcpLr RA_paid _paid __paid
Air Gap inspection: Required minimum air gap separAtlon provided O ym Ono
Remarks:
rea ABOVE REPORT rs mR6gD m Be TRUB
Return Report to oa P e: Plwoe Num
Tom Malphrus,Cross Sh'/r �ae�'3aoy
Connection Control Specialist BRiL MT BY: Cen No, D.
Planning/Building/
Public Works Department REPAtRPD BY: can Ho. Dxe
Water Utility Division
200 Mill Avenue South BY: �A cen Nn. D.te
Renton,Washington 98055
cPoaMsrtnsvenctvLomn,n
. ,
I
Appendix
BACKFLOW PREVENTION ASSEMBLY TEST REPORT
Sv. D417 Return No Later Than:
Name of Premises: Rzo i ld y3/2 /PNAN/ File No.:
Service Address:�� Rilgi ez AU8 S®. /Z ION-j.*JA.
Location of Assembly: INVPIUIT IOOFG <.F, eaRNATR OF21-2.
N Assembly: WR T5 7042 16 -'
Manutacrme, Model Size Senal No
Line Pressure at Time of Test: �S LBS. Type of Assembly:
Reduced Pnawn Assemblies Pressure Vacuum ■reakn
F;
Double Check Assemblies Rolls/ Air Inlet Chock Volvo
1s1 Chock 2nd Cheek Volvo Opened at - _psid
_psId
DC.-closed light IP Closed tight Opened al O,d not - Looked ❑ o-s:'
Initial Test RP _ psid Leaked - 13S d open ❑
leaked ❑
Repairs
and -
Materials __--
Used
Tesl Aker DC.closed light ... ❑ Closed I ght _ ❑ Opened at Opened r -PSI
Repair RP P5W _.Ps-tl 1_Paitl
Air Gap Inspection: Required minimum air gap separation provided ...........Yes ❑ No❑
Remarks:
The Above Report Is Certdl d Be True y '_
Initial 1 ast Performed By� Can No.:_l -1-i—m--o ate
rRepaired By. - 'gate:
Final Test Performed By: _ Cent.No.:
Water Service Restored Yes No❑
Customer s signature
(A 7)
A endix -
BACKFLOW PREVENTION ASSEMBLY TEST REPORT
i J�Gi 2 N!7 Return No Later Than: _
■ Name of Premises: F3 //12'.to/z T)iyA/ T -D File No.:
ServiceAddress: 4G� /�A/NILCI� i�y� So RtN%- Ar ttlA
LocationofAesembly: /. MVAULT. IO"OFF
Assembly:_ (&/ATTr
Manulaolurera`�-L�.1-L�_. S e L s 2 e
8 O
Sena)3enN
Line Pressure at Time of Test: _
LBS Type of Assembly: L?.C,
Nodueed Praattim Assemblies
Preston Vacuum anakor
Double Chet, Assemblies Relief Air Inlet' Cheek Volvo
tot Cheek 211141 Chock Volvo Opened at - —__paid
paid
DC-Closed tight Closed tight Opened ai Did not ---Initial Test RP- - Leaked ❑
—_PSW Leaked ❑Leaked Pad open-------------
.. ❑
Repairs _and
Materials JUL 1
Used
r
Test Atler DC-Closed light ..
Repair '--❑ Closed light ❑ Opened al Opened ate _paid
—_ Paid Pad
Air Gap Inspection: Required minimum air gap separation Provided `Yes ❑ No❑
Remarks:
The Above Report Is Certifie a Tru (/ a.
Initial Test Performed B Cert.No.:'0 Date:�N I Zel—`S
i G'
J Repaired By,
il{ Final Test Performed By: te
tCert.No.: �Qrec
Water Service Restored Yes No❑ �+�
' Customers Srgnalure*�
(A-7)
!i1
7
1Lf +
'PW SSURE 4QC�G;1 BACKFLOW
zod!54520 a PREVENTION ASSEMBLY
5024 Mlrrerd Road W., ` TEST REPORT
Bremerton, WA W312 /
1 RETURN NO LATER THAN
tI
NAME OF PREMISES FILE NO.�L--------I
it
SERVICE ADDRESS
LOCATION OF ASSEMBLY 11N r �a k'T�S�+TJ �r
f. ASSEMBLY. 9,4 � •x r -a..
AMMIFACNAFA MCMk 92F SERIAL AO
LINE PRESSURE AT TIME OF TEST LBS. TYRE OF ASSEMBLY_
Raduoed haven Aaaembees Pleaeen greenest Maker
Double Check Aaeembeae ROM Air WM Chock Val"
tat Check bid Check VMae Opened at
__Pstd .—Psid
lndial DC-closed tight Closed tight Opened at Did not
Test RP._psld Lacked ❑ —Psis open ❑ Leaked ❑
Leaked ❑
Repairs
and
Materials
Used
z
Test After DC-Closed tight ;, Closed kgnt 7i Opened at Opened at _—pale
Rama RP Paid Psd __.psid
AIR GAP INSPECTION-. Reouued mmimpm air gap separation Provided Yes No
l-
REMARKS,
THE ABOVE REPORT IS CERTIFIED TO BE TRUE. •/
lITIAL TEST PERFORMED BY "` � `"s 0 S✓' CERT.NO Gam;.° �— DATE----
REPAIRED BY _____—_ _—.— DATE
FINAL TEST PERFORMED By CERT NO _. _ -- DATE -,
E.
Y
r,V!a
� a r
CITY OF RENTON
Planning/Building/Public Works Department -
Hart Clymer, Mayor
April 11, 1995
Ken Booster �� 1 Fred
Fred Meyer 8BU11/pVl'/l/ a„�
P.O.Box 42121
Portland, OR 07202 �I1
SUBJECT: NEW 8 INCH WATER LINE AT RENTON FRED MEYER /
Dear Ken:
The City of Renton would like to have the existing 4-inch leaky steel water line north of the new Fred Meyer,
replaced with a new 8-inch ductile iron water main. The new 5-inch water line will provide additional
reliability to the 12-Inch water line around the new Fred Meyer complex.
We have reviewed the cost estimate submitted by Fletcher Wright Inc.In the total amount of$44,427.00,
y.,
Y
The City would like to participate in partnering with Fred Meyer in the installation of the new 8-inch line and
we propose the following'
Instead or the monetary cost-sharing,the City will provide the following:
• Attached red-lined civil plan showing the location of the new 8-inch line
• All required new 8-inch ductile iron Class 52 p-pe and finings materials and polywrap material for the
new 8-inch watet line
• All necessary copper water service and fittings to connect the existing water meters to the new 8-inch
line
• Labor to conned the new 8-inch line to the existing water lines on Rainier Avenue and on the south end
of the new water 8-inch line
• Provide"poly-pig"and perform chlorination of the new 8-inch line
Fred Meyer or as authorized sub-contractors will provide all labor, materials and equipment to perform the
following:
• Trenching, shoring, select trench backfill, compaction and asphalt patch for the new 8-inch water line,
service lines and Connection points.
• Installation of new 8-inch ductile iron pipe and fittings with polywrap, copper water services, connection
to existing water meters i
• Concrete thrust blocking at finings and at connection points as required
200 Mill Avenue South-Renton,Washington 98055
is
Pape 2
April 11,1995
• Perform the cleaning by'Poly-pig-of the new line with City's furnished'poly-pig"
• Pressure teat all new 8-inch pipe and finings per City's specifications
• All required traffic control for work on Rainier Avenue,temporary cold-mix patch and final asphalt patch.
• All required construction staking and as-built drawing of the new$-inch waver line
• A fifteen-fool wide utility easement to the City for the new&inch line.
1 have met with Jimmy Dale, the project superintendent for Fletcher Wright Constmclion, and have
discussed this proposal with him. However,no work will be done until we receive a concurrence and written
approval of this Proposal from Fred Meyer.
Please call me at(206)277-6210 if you have any questions or need additional information on this matter.
Thank you.
SiTcorely,
l�(SIbLLL �SftFrNrQ�
Abdoul Gatour
Water Utility Engineer
H U1 ILIWATERA64"G bGGAG:a
a'. Jwvey G•I•-FMrlrr WaaM fart.
LA H.m•bl' Ray SNe,NM Watls-r;,ry M Ruft
i
•
r�
r
Y
r,
Frmo ftzr
KEN BOOSTER
PRWFCT Mµ��ER
CON TRy TpryEEC_T'EMENT MPARTMENT
P o R x 42121
(507913", Pal M 9124
E I5991 T9T.J539 99WSE 22NAw
PwtVvtl.CR 9M2
I
J
w
4 H "Al
BEGINNING
OF FILE
FILE TITLE
l
I
i '
11�
At
�T
).r
PROJECTCLOSING i{ Final Coyn tr
FINAL COST DATA AND INVENTORY ands
SUBJECT: FRED MEYER CITY PIIOJr:CT Numni nS. writ. 2165
w,vP- 2165
2165
Naas of Pin TRO
TED.
TO: City of Renton FROM: Qn.., is,
Plan RevkR,Section �Yw gar u0
Planning/Oullding,TtlhRc Wnhi EaypT ..An 47gn
200 MIR Awnt,e South
Renton,WA 9e055 DATE: _1� Y A.1 A4t3S
Pcr the request of the City of Renton,file following information is furnished concerning final costs for -
ionprovcments installed for the above referenced project.
WA RSYcTM CONSTRUCTION COSTS TRa7,715-0
Length sift //4,A wo
Sac) LF.of t a' �=WATERMAIN VL,739
12gL,_ LF.of /L-1 WATERMAIN //0a31L�
GVO LF.of gat WATERMAIN 61s,7L�
LF.of WATERMAIN
Z. EACH of 9. -- GATE VALVES ,�SLL,LII TOTCI.
/. EACH of TjLa GATE VALVES
GCH of ,Y• �_4AXG-W*44g
EACH of IGWA FIRE HYDRANT AS.SI:MM.IFS S /pJ Eno
(Cox of Fire Ilydrintc must be listed separately) 3 /p Spp
(Include Enitinecnngard Saks Tax lfapplicabk S
TOTAL COST FOR WATER SYSTEM f Uj7x7T40
SANITARY SEWER SYSITK STORM DRAINAGE SYSTEM
Length Stu Type Length Size Type
13aG� Lr of /e•, • may SEWER MAIN _jg:Q_ L.r.of 1Z,� NDi- STORMDNE
/AS I..I of W. �� SEWI:R MAIM L.P.of STORM UNL
LF of SEWER MAIN LF.of _ STORM DNR
LA of y8M • DIAMETTR MANIl0LES rA Of STORM INLEr/OVELTf '{
GA of DIAMeR MANIKKES �� rA of �� STORM GTCIIMVN ��
0nchdirlg Enµnecdng and9b Taa I—._ EAof _3` STORMGTCImASIN
d applieaMc) f Moo (1- win r.
a nm"ee,+nx stint Saka Tat
T0TAL COaII0aSANITARY SEWER FYSIIM t q6./_uA dq•pLabq) a 3L39
mTAI.Cn tuft.roAM I)RAINAGEWSTEM E da730
51'RE[f IM I'l10VI.AIIfNiS' OMludnig Ludl,Guner.SdcwaR,AaphAh Pannmm and Sllcct I ighunµ)
IIO z�_A! �E'LM <ti cpY T 7:,PSL LC ! �� jucf m; SF 10E .Qi�
SIGNALI2A'TI0N (Including hng Design Coin,City Pemw Pecs,WA 5,Satcs la.) _—
LI/A
STREET LIGI I1'ING (Including Ene rks,gn Dons.City Ihnmt Fa'c'A,WA St Saks Tax) --
iFJ_�& 7L'_._ �1 L Fs ._L�i-aS t L.uayaR�AtYEt�
'Atli lei' =,T PIZo.iEtT /'1AVpL.tY 797-
Pnm a�gwrnO nameP2
J.q Plunw
Iu•m.n us n u I:I n u ne' (Stgnaw.) unnl le amb,Rucd agun
or owov.d.nhl.a,k,chpm,cM)
M
t 4 �
i
WTR 2165 ''K
WWP am
SWP 2165
/ 2165
EXHIBIT 'A' TED e
Watermain Improvements
352 liner feet of 16' Ductile Iron watermain
1.556 lineal feet of 12' Ductile Iron watermain
940 lineal feet of 8' Ductile Iron watermain
2 each 8' gate valves
6 each 12'gate valves
2 each 16' BV
8 Standard Firo Hydrant Assemblies
k
Sanitary Sewer Improvements
1,306 lineal feet of 10' DIP sanitary sewer main
S�
185 lineal feet of 8' DIP sanitary sewer main
i.
6 each 48 inch manholes
.$tor lr Cjjr_Systern lmorov ,airs °'al
420 lineal feet of 12' HOPE storm line
25 lineal feet of 8' HOPE storm line
a.
2 each 48 inch Type II Catch Basins
6 each Type I Catch Basins
a,5et Improvements
3,200 square yards asphalt
2,072 lineal feet of curb and gutter
14,568 square feet sidewalk
12 each poles and luminaires
4
wquca�