ENG20170130-Pre Inspect Form.pdf
PRE-INSPECTION REPORT
106323082
Job #:
2/25/179821 228th PL SW
Date:Address:
EdmondsEdmonds 98020
Jurisdiction:City / Zip:
Travis 360-420-3699
YES NO
Right of Way Permit?Customer:
CUST PHONE NUMBER
A.Baunsgard 425-495-4465
Est. Start Date:PM / Insp:
Est. Duration:PHONE NUMBER
Construction Method
WORK DESCRIPTION:
Open Trench
Trenchless
PLAT MAP:
N
A425 MSA
1137
1-1/8 PE
46' scat stub
100' scat
extension
W
e
v
A
h
t
8
9
Work Location
Size of Cut Surface Type
16 'N S of CL228th PL SW17 'E W of CL98th Ave W 2x5Asphaalt
&
'N S of CL 'E W of CL
&
'N S of CL 'E W of CL
&
FLAGGERS # TROLLY LINES BUS STOP # METER HOODS #
125
MPH
SPEED LIMIT
OFFICERS # TRAFFIC SIGNAL ARTERIAL
NO PARKS #
Service Information
Commercial Altered Commercial Leak Repair Template Bar
Diameter Meter EFV
Residential
Altered Residential CP Work
Bollards 2.5" #
5/8" 250 1800
Multi-Family
Replacement Service Pothole
Bollards 4" #
New Constr. 11/8" 425 2600
Main Maintenance Extension
Stub 11/4" 630 10,000 FUEL LINE PERMIT NEEDED
Service Maintenance
Extension 2" 1000
Valve Maintenance
Fuel Line Length:
Compete Serv
Cut & Cap
Mtr Loc:
Fuel Line Diameter: