ST9302-CR000316VATER MAIN CONSTRUCTION
NSPECTOR'S DAILY REPORT
C~TY OF O^LL^S W^TE.
;ATION AND DESCRIPTION OF JOB
CONTRACT NO.
.OURS= F'?*/ r~ TO I ?- ~'/:
REPORT # / 7 page / of...L
?¢/3/!//--
WORKDAY{ 1¢/' YES) { NO. WHY?)
)CATION OF LINE ~ "
IUANTITY ITEM STATION ~ ITEM #
Ft. Class Emb. in Rock "' '
Ft. Class ~ Emb. in Earth ' ~, ~. 70(1
Ft. Class F~ Gr. Mat'l ,,
Ft. Polyethylene Wrap
Ft. Pipe: Size Type --
Ft. Class Emb. in Rock
Ft. Class Gr Mat'l
Ft. Polyethylene Wrap
:AD HEAD SERVICES INSTALLED
UANTITY SIZE BLOCK LOT NO. ITEM
EA. INCH
EA. INCH
TINGS, VALVES, FIRE HYDRANTS, PAVING, ETC.
NUMBER
ITEM
DESCRIPTION
__ Ft. Inches Thick Over Pipe: Stations:
__ Ft. Inches Thick Over Pipe: Stations:
J #Concrete For: Location:
Cy Rock Foundation Location: '
Cy IStab. Backf Location: : '
ITEM #
PROGRESS OF BACK-FILL AND CLE?-UP WORK SATISFACTORY?~
TY PROPERLY BARRICADED?~ NO. PERSONS WORKING ON, OB:
(CONTINUED ON REVERSE
SIDE IF REQUIRED}
the Contractor:- I agree that the above report is correctwith the following exceptions:
: FORM 171 WTU-01129
ARE ALL DITCHES AND OTHER OBSTRUCTIONS AND HAZARDS TO PUBLI
COMMENTS:
/ /
INSPECTOR
FORMAN