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Structural Observaton Gro <br />A California Corporation <br />8941 Atlanta Ave.,#518 <br />HuntinSton Beach, CA 92545 <br />up, lnc. <br />s 24-Hour Pager (949) 227 -8668 $ , <br />u 0 0 ro| Free Fax (877) 764-3939 <br />H-I FLI S/UJ N/C Dc0 <br />ll/e Just Do A Better Job!Co4 c..-l-<-- <br />Observation Report and Obsen ation Agreement <br />City <br />Job Name <br />Malerial Description Engineer <br />Samples:x Quantity= <br />Description of Work Observed: <br />t <br />Certification of Compliance <br />We hereby cerrlly rhar, ar rhe rime oi lh6 ob*dauon, we have obw€d at1 ot rhe above <br />eporled wo , unl6s othetuis€ .ot€d To the best ol o$ knowl€dgo and beliel. w€ have ,ound <br />lhis wdk to comply wth lhe appoved plms, specilications, and arplcabre se.t on(s) ol lhe <br />Unllom Bui d ng Code, as applcable ro th€ lea ity where this prot{l s r@ated. TIis epon <br />cannol be conslrued lo be a reomrendation ol work ol any natue 10 be pefomed. Ihe <br />penormance ol our obsdaiion *B es is sobt&l to the tems ad conditions G de$ribed m <br />fte ev€rs€ sde ol lh6 Obs4arion Bopod. Tn€ Owner or a s@ess io inlsEt shal hold <br />hamrs Sklclural Obs€oat on Goup, lnc. llom any and all legalp@e€dlngs ol any natu/e <br />whalsoever, lhal s relal€d to the ob*rualion serv c€s prov d6d. <br />Signature of Registered Observer <br />Specialty No <br />:. ..r'.'j]., <br />ri ':1".' a-.'.: .l I <br />.'..? .a': t <br />.:' <br />.',.:. r.i':r <br />i.1,;: <br />::n <br />By this signature on the this 0bservation Report. I acknowledge <br />that SOG, lnc. performed the above observation. <br />Project Superintendenl - Foreman - Other <br />Approved by: <br />WHITE-OFFICE COPY CANARY-ACCOUNTING COPY PINK-OBSERVEFS COPY BOTTOM WHITE-JOBSITE COPY <br />Agency <br />I <br />Nc <br />DATE: