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Structural Observaton Gro <br />A Calilornia Corporation <br />894 I AtlanuAve..#518 <br />Huntington Beach, CA 92646 <br />up, lnc. <br />s 24-Hour Paser (949) 777 -8668 $ <br />0 0 rolr Free Fax (877) 764-3939 <br />Hr F-l 5/U _r N/C r0 <br />$re.zs <br />We Just Do A Better Job! <br />Observation Report and Observataon Agreement <br />City <br />I <br />Malerial Descnption Eng.neer <br />Observer <br />Samples:X Quantity= <br />Description of Work Observed: <br />Certification of Compliance <br />We hereby cenry $al al lhe lime ol lhis obseNaton, we have ob*Bed all oi the above <br />eporled wo.t un es dheMM noled. To th€ besl oi ou knowledge and b6liel, we ha!€ tolnd <br />lhls wdk to comply w h lhe approved plans. s!€crfical@os, and app icabto *tron(s)ol L\e <br />Ur lorm Bullding Cod€. as appli@b e lo the l@allty wh* this proiect is located Tlis Epon <br />cannol be construed to be a reomoedanon ol wolt ol any nature to be perlonEd. The <br />p€rtofrance ol our ob*ryarion wrces s subjet ro rho roms and conditions 6 dscnbed on <br />lhe reve.se sde of this Obsrualion Bepon. Tne Ownd or a successor ii i|t@sl shan hold <br />ham 6s Strwtu.al Obwryallon Grclp, lm. ,om any 3nd al legal p@6dings ol ay Mture <br />whatsoover,lhal 6 real€d lo the obsetoaton sces povd€a. <br />Signature of Registered Observe. <br />Specialty No <br />I <br />Nc <br />DATE: <br />:: . ?,i,':g <br />:-.,.i.i..j.- <br />;1' <br />n <br />t <br />al <br />!, <br />al <br />:_a :. <br />it'r?, <br />By this signature on the this Observation Beport. I acknowledge <br />that SOG, lnc. perlormed the above observation. <br />Prcject Superintencleni - Forcman - Othe. <br />Approved by: <br />i.t, ;:,11'-'-':' <br />IIYHITE-OFFICE COPY, CANABY.ACCOUNTING COPY PINK-OBSERVERS COPY BOTTOM WHITE.JOBSITE COPY <br />Agency