Georgian Place-CS000404 (2) MEMORANDUM
FROM THE
DEPARTMENT OF PUBLIC WORKS
To:
From'.
Date:
RE:
Larry Davis, Construction Inspector Engineering
Danny Hightower, Utilities Division
April 4, 2000
Walk-thru Georgian Ptaee
1. All O.K. on Utilities portion.
CITY OF COPPELL PUBLIC WORKS DEPARTMENT
MESSAGE
CONF I RMAT I ON
04/04/00 15:51
ID=CITY OF COPPELL
DATE
0~%04
S~R-TIME DISTANT STATION ID MODE PAGES
00'35" CITY OF COPPELL CALLING 02
RESULT
OK 0000
Check for' A.::u:ac~ test: Meter Leak:
rniBa~ .,-n.e:~.': re[ocat',oo x~.'zez~oas
1.. Backflow Lns~. 2. P--el~air 3..MaL-nenance 4. Q~er
Backflow [nsp. A. Mom Line A. P~.tmp A. Line Locate
BkIlow Cert. Date B. Valves B. Water Tower B. Line Locate
Re-Cert. Date C. Service Line C. Samples C. Tap
D. Hyck:mts D. Equipment D Excavation
E. Safety
5. Reason for failure: A. Elec~olysis B. New Consmictiou C Poor In~!!,¢ion D. Other
6. List of safety equipment at site if applicable:
A. Barricades B. Cones C. Tape D. Lights E. Other
7. If Meter/Service Leak: Classify: - City:
A. Water Loss (esumate): GPM __
B. Was Water Metered: Yes
C. Was Customer Notified: Verbally
$. If Mere? Change
A. Old Meter -' Reading
B. New Meter = Reading
C. Old Meter SooT?ge:
E. Type of work .:~':..'ormed or f'mdingi:
Fixe plug flushing
No
Total Gallons
Doork=ocker -
Vehicle~Equipment Used
Unit # Miles I-ks Equipment
D NewMeter Size:T~Te
9. If mai~ii.ne or deep service repair, describe LYpe of pipe ar service line and condition:
t l. Ltsr Ma:enais Used:
13. Water Utilities meter tz.%:ection: pass or fail
14. How many raps to do :oak?
Signature
- WATE ~J'
i. ~ackflo',v Lam 2. Re=air 3. Maintenance 4. Other
Backflow [.qsp, A. Main Line A. Ptanp A. Line Locate
BElow Cert. Date B Valves B. Water Tower B. Line Locate
Re-Cer.. Date C. SeN'ice Line C. Samples C. Tap
D. Hydrants D. Equipment D Excavation
E. Safety
Reason for failure: A. Elec~olysis B. New ConsUuc~ion C Poor I~s~alion D. O~hcr
6. List of safety equipme:t at site ii'applicable:
A. BarA. icades B. Cones C. Tape D. Lights E. Other
7. If Mercy Service Leak: Classify: - City:
A. Water Loss (esSmate): GPM __
B. Was Water Metm'~h Y~
C. Was Customer NotLqed: Verbally
Fh-~ plug flushing
No
Total Gallom
Dcork:ocker -
[. X ...... aang. Om:
V:',,"cl,Equipment Used
L'm: ~ ,',fries Ers Equipment
A =rd Me:er = Reading
3 Ne';,.' Meter = Reading
C Old Meter S:.zsT??e:
E. Type of work .:~..':..'onmed or findings:
D ",'ew ¥[e er
9 [f w. a25. me or deep ~e.",i:: re=ak describe E,.'pe of piFe or serlio', line md :=edition:
1:3 ','. i..-- .... ._ _., Cre'a M.~mbers.
[2. if you k~d ~a :to:Ldo-n: L"::de:'.t while FerS:,.'-mmg this ::quest. Did you :eTcr: it? Yes or ag
13. Water Utflines meter x-..17ection: pass or fail
I4, How ~2.ay a"ips r= do :.~k'~
Sqnam:~.