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Type of <br />lnsp€ctaon <br />Requlred <br />D weams <br />E ttigtrstrengfir aohing <br />fl rirc Prooflng <br />[} Reinlorced Concrete <br />I Post-TensionConcrete <br />I Reinlorced Masonry <br />I shotcrae <br />D Epoxy/Dta <br />! otfrer._-.-_-_ <br />Proiect # :Permit: \o\9.!3J7Proiect: Tt rc L=nv;ortm?ntq.,\- <br />A,IJurisdiction:Address: 2€OO S. &rnse s+.. B\#B <br />Architecl:Type of Structure: $,. O . G , <br />* €rt eciEngin6€r:Matsriaf D€scription: A ncreff <br />Conlractor:lnsp€ctor: '-liizrl 7;11 Mo r-a.,2 <br />Subcontractor <br />Type of Sample Slump Ouantity <br />t/v q+ <br />Bill to <br />lnspection Summary: <br />(/ <br />C <br />Registered lnspector's Daily Report Date d- tr-r 8 <br />IN <br />W6 hereb cenitv thal. at lhs lim€ ot this insDoction, wo hal/e ob6ewed all ol <br />lho abovdteoort-ed work. unl66s otherwisg ilolad To the bsst o, our knon'l' <br />€doe aid beliel. we have tound *lls wo.k to comDlv wllh the approv€d plans. <br />so&incations, and applic&le soclioi(s) ol lhe Unitotm Building Cods. as <br />abdicabl€ !o thg l6fr[ty whqo O*s ptoircl is located. Thi6.eported cannot <br />bo consirued b be a .econrneidaion ol work ol any nalure to be p€.totm3d. <br />5,AA <br />The DedormarEe ol our obseryation sewicas is sutioc,t lo trle tetms aIld <br />coadiiions as describsd on tlte rov€/se side ol tl'tE Obaervahon REpod. The <br />o\.nrgr or a s{rcc€s3or in intaresl shall hold harmloss Allctty hspeclbn <br />Sewice lnc-. trom legal ol any nahjre whgtsoovet. <br />9y rhis signature on the Observation Reporl, I aclnor/edge fiar <br />ACIS. hc. perto.med me above observallon and am bound by lhe <br />that is related lo tlle sewices <br />terrns and corditioos on the aever6e rcPot1. <br />TIME OUT <br />Io ,AA <br />r.5x <br />Approved by: <br />Proracl - Fo.a6tn - Olh€r <br />and <br />e of Regisbred <br />ACIS Proiecl #: <br />Tests Performed <br />K <br />o <br />F-lt <br />I <br />I <br />i <br />l, <br />(e^N*e 6q56.o 97 i,,S-peashy NU Agency