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11B158WQ-11B158F PACIFIC INT-R-TEK PACIFIC INT-R-TEK Office:503-665-1090 A Division of Scott Pipeline Video, Inc. Website:tvmypipe.com 2501 NW Division St PIPELINE VIDEO REPORT Email:office©tvmypipe.com Gresham,OR 97030 OR CCB#146869,WA PACIFI*991CW Surveyors name Certificate Number System Owner Survey Customer Drainage Area Sheet I Adam Scott 11 U-512-15316 I I City of Tiaard I I Kerr I I I I 1 P/O No. Pipeline Segment Reference Date Time Location(Street Name and number) Locality 08/26/2019 1110:30 AM I I SW Jason Ln I Tigard I Further Location details Upstream Manhole Number Rim to Invert Grade to Invert Rim to Grade 111 B I 111 B158WQ I I I I I I I Downstream Manhole Number Rim to Invert Grade to Invert Rim to Grade Use of Sewer Direction Flow Control Height 1 116158 I I I I 1 I I I Stormwater I I Downstream I I 1 1 999 I Width Shape Material Ln.Method Pipe Joint Lenath Total Lenath Lenath Surveyed Year Laid Year Rehabilitated Tape/Media Number I Circular I I PVC 1 I 1 I I I I 87 I 11 30156 I Purpose Sewer Category Pre-Cleaning Cleaned Weather Additional Information 1A I I I I Jettina I I I I Dry 111"TEST BALL AND WET LINES I Code Value Circumferential Distance Continuous Location Struct. O&M defect Joint Image Ref. Grade Grade (Feet) Group/ Modifier/ S/M/L I % At/ To Descriptor severity 1st 2nd From Remarks 0.0 AMH Starting Manhole: 11B158WQ 0.0 MWL 5 87.0 ADP 11B158F Structural I 0 & M I Overall N M Nr in r N M Tr u, .— N M Tr in a) a) a) a) a) c x a) a) a) a) a) c Y k a) a) a) a) a) c k -a 'a 'a 13 V y 'a -0 'a 'a • C) y -0 -0 -0 'a V y et co Co et cC ++ tC !C et tC a et cC cC R co ++ L L L L L (C •� L L L L L (C •3 L L L L L R •� -13 Segment C9 (7 (7 C9 (7 re CJ E 6 C9 C9 c9 C7 ( Cl c C9 c9 c9 c9 C9 re 0 E 11B158WQ-11B158F 0 0 0 0 0 0 0000 0 0 0 0 0 0 0000 0 0 0 0 0 0 0000 Generated on Monday,8/26/2019 at 10:40 AM by the PipeTech®TV inspection system. PACIFIC INT-R-TEK PACIFIC INT-R-TEK Office:503-665-1090 A Division of Scott Pipeline Video, Inc. Website:tvmypipe.com 2501 NW Division St PIPELINE VIDEO REPORT Email:office©tvmypipe.com Gresham,OR 97030 OR CCB#146869,WA PACIFI*991CW Upstream MH Downstream MH Size Material Total Length City 11 B158WQ I I 11B158F I 999 I Polyvinyl Chloride I I I I Tiaard Surveyor's Name Certificate Number Street Address Location Details I Adam Scott I I U-512-15316 I I SW Jason Ln I 111 B I Direction Purpose Weather Date Time Length Surveyed I Downstream I I Maintenance Related I I Dry I I 08/26/2019 I I 10:30 AM I I 87 I Additional Information Project Name Media Label 11"TEST BALL AND WET LINES I I Erika Ct I I 30156 I Ftg. Code Description Position Comment °0.0 AMH Access Point-Manhole Starting Manhole: 11 B158WQ °0.0 MWL Water Level 1( ::j V 087.0 ADP Access Point-Discharge Point 11B158F Generated on Monday,8/26/2019 at 10:40 AM by the PipeTech®TV inspection system.