Town Center West-CS010126 01×51/01 16:05 CIT..~Y OF .~.~OPPELL ENGINEERING ~ CITY O~COPP~L NO. 9?9 Q~2
8i/~6/B1 11:44 CI'~ OF C~,'PELL ~ CITY ~ ~EL ~.~ Ri
~ORANDUM
FROM THE
DEPARTMENT OF PUBLIC WORKS
To:
Dmny H~Mower, U~ltas D~v~on PulSe Work
J~muary 26, 2001
Walk-~ru Town C~n~r Wes~ Bluck A, Lot I
Need leek latch for vault.
~' Mark on curb F.H.V. m red.
~. Nmi mere' elm tubed, leo low.
1,6;~ N~I D.C, ust on in'. & viuit imperworK.
~ ~ l~-k oa cu~ II, m, & Irt in blue.
cffl~ OF COPJ~F.J~L P(MIJC V/Ol~J~ D£pA.qTM£)h'
Phone Numl~. ('['~V0
Check for: Accuracy test:.
Initial meter relocation inspections
WATER
Employee: ~ Grid map:
(va<):
Meter Leak: Check water pressure:
Re-read
Bacldlow Insp. A. Main Line A. Pump A. Line Locate
Bkflow Cer~. Date B. Valves B~ Water Tower B. Line Locate
Re-Cert. Date C. Service Line C. Samples C. Tap
D. Hydrants D. Equipment D Excavation
E. Safety
5. Reason for failure: A. Electrolysis B. New Construction C Poor lns'~llstion D. Other
6. List of safety equipment at site if applicable:
A. Barricades B. Cones C. Tape D. Lights E. Other
Request for Set. ices:
( . ,.
7. If Meter/Service Leak: Classify: - City:
A. Water Loss (epi,~.te): GPM __
B. Was WaterMem'ed: Yes
C. Was CnstomerNotilied: Verbally
.Fkep~gflushing
No.
To~ Gallons
Dooflmock~ -
8. IfMeer Change Ou~
Vehicle/Equipment Used
Unit ii Miles Hfs Equipment
A. Old Meter # Reading
B. New Meter it Reading
C. OM Meter Size/Type: D New Meter SizeFl'ype
E. Type of wodc peri'ormed or findings:
9. If mainline or deep service repair, descn'be ~ of pipe or service line and coodi~ion:
10. Man-hours:
11. List Materials Used:
Crew Members.
12. If you had an accidencqncident while performing this request. Did you report it? Yes or no
1B. Water Utilitic~ meter im'pection: pass or fail
14. How m~ny uips to do lzsk?
Signatur~
~.-..C..~. ~:~. C. Se~.¢e Line C.
D. H.vd~
B. W~sW'~mmd: Yes
?. r,- ~.-~--'S,Tdct ~ (2h~iL~. - City: