ST9302-CR000331VATER MAIN CONSTRUCTION
INSPECTOR'S DALLY REPORT
CITY OF DALLAS WATER DEPARTMENT
HOURS: TO
REPORT, ~0 Page / of-.~.--
)CATION OF LINE
)UANTITY ITEM STATION ITEM #
Ft. Pipe: Size Type
Ft. Class Emb. in Rock
Ft, Class Emb, in Earth
Ft. Class . Gr. Mat'l
Ft. Polyethylene Wrap
/
Ft. Pipe: Size Type
Ft. Class . Emb. in Rock
Ft. Class Emb. in Earth
Ft. Class ,.Gr Mat'l
Ft. Polyethylene Wrap
! EAD SERVICES INSTALLED ' '
UANTITY SIZE BLOCK ?,, --:i: LOT NO. ' ITEM #
EA. IN CH
EA. INCH
'TINGS, VALVES, FIRE HYDRANTS, PAVING ETC.
ITEM NUMBER DESCRIPTION ITEM #
Ft. Inches Thick Over_ Pipe: Stations:
__ Ft. In~ches Thick Over Pipe: Stations:
#Concrete For: Location:
Cy Rock Foundation
Cy Stab. Backfill
Location:
Location:
ARE ALL DITCHES AND OTHER OBSTRUCTIONS AND HAZARDS TO PUBLI
{E PROGRESS OF BACK-FILL AND CLEAN-UP WORK SATISFACTORY?
(YES OR NO)
7fY PROPERLY BARRICADED? NO. PERSONS WORKING ON JOB:
(YES OR NO)
(CONT)NUED ON REVERSE
COMMENTS:
SIDE IF REQUIRED)
the Contractor: -- I agree that the above report ~s correctw~th the follow ng exceptions:
INSPECTOR
FORM 17~
WTU-01129
FORMAN