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1609 Central Avenue S, Unit#2 • Kent,WA 98032 Date 2 • /s , /4 Invoice No. 38484
Phone 253.856.2572 Fax 253.859.5087
Customer A(R't V Site Contact -re 77 Phone# 20C ..'''`IL 7. 17 7 4
Job Name: 7 7-7' Job# P.O. #
Site Address 2/0 1)0/744 dL //VC S�. City ;.A✓70/ State /4/,4 Zip
Billing Address /' City State Zip
EDUCTOR TRUCK: TECH AD�BRL TRUCK# TRAVEL ON SITE TRAVEL W/DISPOSAL
START START: / START: } ��
Type l# Type II# /0, J� t /. 3 0 ! 0
Storm System OWS y A/V p U�
t� END: END: END:
Vault Sewer ��. � i•'0 t. f• d (,.,�
Hydro-Ex Jetting
ADS Used El Yes ❑ No Description of Work Performed HRS/ UNIT TOTAL
Disposal On Site❑Yes• ❑ No LF PRICE AMOUNT
Disposal Site Used ' i /
CCTV INSPECTION: �� ��� K '� ���
Push Camera❑ Main Line®. I 20 i X 12 'r $7-6f'rLv
Locate ❑Yes❑ No
Sewer[ - Storm®- 1.L
DVD: r Reports: !! ,
SAW CUTTING:
Asphalt/Brick: ❑ -
Concrete: ❑
LF Depth
Vacuum Labor /Hrs.
Slurry Drum/s
Relocate /Each
PRESSURE GROUTING:
Seams Vault
Pipes 'Diam.
CB's Type.1❑Type 2❑
SMH's Diam.
CONFINED SPACE
EQUIPMENT:
Required Yes ❑ No ❑
• MATERIALS USED:
Seal Foam Pure Gals.. •
Cut Pure Gals.
AC-400 Gals.
Speed Plug Pail/s
Fast Patch 50#Bag/s
1/2"Packers Each
SEWER/STORM TAP:
E
Tap: Dia. Qty. o
0
Pipe Material
CORING:
Dia._Depth 1 Qty.
Dia._Depth Qty. X
Dia. Depth Qty. Sub-Total
THRU-CHANNEL: Tax %
Yes No . -
Dia. Depth TOTAL a
KQ_R-N-SEAL: Payment:S/B Check# Cash Terms: Net 30 days. a
Size Qty. Credit Card# Exp. 1 1/2% Per month
INSERTA-T delinquency charge on Y
Size Qty. Additional work needed ❑Yes ❑No past due accounts. $
% PERSONAL GUARANTEE
By my signature below I have accepted personal liability for all amounts due Puget Construction Services,Inc.,for the above mentioned services,and promise to
make the payments as agreed:WHEN WORK IS COMPLETED.
I fully understand that in the event that payments are not made as agreed,thatl,have assumed person I liability for all unpaid amounts including all actual
collections fees,all actual attorney// fees,plus all costs incurred to pursue under/law all amounts due)Cget CC�onsfruction Services,Inc.,
c1:6-07-A N Z t J i ryf .,_._ 5. / r17e 4'"/ j/.1iAA ., Date: 9 -( --/
PRINT YOUR NAME POUF SIG7fURE
3-- Puget Construction Services _,—
1609 Central AVE S. rtilpUGET
ii.j‘r -Q-
Kent,WA 98032 4.,.1--1
ONSTRUCTION
Phone: 253-856-2572 Fax: 253-859-5087
CERVICES, INC.
Project Name: Asset ID: City: Address:
DEWITT SHORT PLAT DSP MH2 TO DSP MH3 RENTON . 210 DUVALL AVE SE
Date
Pipe Width: Pipe Height: Pipe Type: Surface Condition:
8/15/2014 8 8 PVC Asphalt
Direction: Surveyed Footage: Weather Tape/Media#
Upstream 134.2 Dry
DSP MH3 0
fr. f. At134.2 ft./.
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Puget Construction Services
,1609 Central AVE S. IiRGFT
Kent, WA 98032 CONSTRUCTION
Phone: 253-856-2572 Fax: 253-859-5087 ` EItVICES, INC.
Project Name: Asset ID: City: Address:
DEWITT SHORT PLAT DSP MH3 TO DSP MH4 RENTON 210 DUVALL AVE SE
Date Pipe Width: Pipe Height: Pipe Type: Surface Condition:
8/15/2014 8 8 PVC Asphalt
Direction: Surveyed Footage: Weather Tape/Media#
Y
Upstream 154.3 Dry
DSPMH4tO --
j' Cr gt154.3ft.J.
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TV Inspection with Pipe-Run Graph Page 1 of 1
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t, Puget Construction Services
1609 Central AVE S. UGET
Kent, WA 98032 4/4ONSTRUCTION
Phone: 253-856-2572 Fax: 253-859-5087
::.�ERVICES, INC.
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Project Name: Asset ID: City: Address:
DEWITT SHORT PLAT DSP MH2 TO DSP MH1 RENTON 210 DUVALL AVE SE
Date Pipe Width: Pipe Height: Pipe Type: Surface Condition:
8/15/2014 8 8 PVC Asphalt
Direction: Surveyed Footage: Weather Tape/Media#
Downstream 12.9 Dry
DSP MH2i ,,-:
]1,!sem Ato.Oft./. 00ft
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TV inspection with Pipe-Run Graph Page 1 of 1
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Puget Construction Services
1509 Central AVE S. - ' 'UGET
Kent, WA 98032 ONSTRUCTION
Phone: 253-856-2572 Fax: 253-859-5087 '
c ERV ICES, INC.
Project Name: Asset ID: City: Address:
DEWITT SHORT PLAT DSP CB2 TO DSP CB1 RENTON 210 DUVALL AVE SE
Date Pipe Width: Pipe Height: Pipe Type: Surface Condition:
8/15/2014 12 12 Other Other
Direction: Surveyed Footage: Weather Tape/Media
Downstream 121.8 Dry
DSP CB2I0 ,
G,y At0.0ft./.
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DSP CB1
TV Inspection with Pipe-Run Graph Page 1 of 1