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lil NATIONAL INSPECTION & TESTING <br />SPECIAL/DEPUTY INSPECTION REPORT Job No o"" 12-20-2017 Time <br />TYPE OF <br />INSPECTION <br />REQUIRED <br />Reinforced conoete <br />Posl Tensioned Cohcrote <br />Stnrctural Ste€l Assembly <br />High Strength Bolts <br />Quality Control <br />Epoxy <br />OthorReinforced Ma Fire Proofin <br />TESTS PERFORMED <br />SUMMARY - LOCATIONS OF WORK INSPECTED, TEST SAMPLES TAKEN. WORK REJECTED. JOB PROBLEMS , PROGRESS. REMARKS, ETC <br />Verified installation of #4 footing dowels and #4 slab dowels at exterior and interior footings <br />and slab using Simpson Set XP epoxy ICC ESR 2508 per details on approved plans. <br />Work was done in accordance with mfg. specifications. <br />TERMS:BILIING AT4 ANO 8 HOURS MINIMUMS, WTH 2 HOT,R CHARGE FOR CANCELLATIONS, SHCI,,LO NIT 8E REQUIRED TO INSTITUTE LEGAL ACTION FOR TIIE COLLECTION OF <br />A OEET INCURRED AS A RESULT OF ACCEPTANCE OF THIS SERViCE TIC(ET NIT WILL BE €NNTLED TO ATTORNEYS FEESAIIDCOSI INCURREO IN SAID SUITE- <br />THIS FIELO REPORT PRESENTS A SL}MMARY OF OBSERVATIONS AND TESTING BY NATIONAL INSPECNONA TESTING PERSONNEL OR SUE.CONTRACTORS, OUR WORK OOES NOT <br />INCLUDE SUPERVISION OR DIRECTION OF THE ACTL,A! WOR( OF THE CONIRACTOR, HIS EMPTOYEES OR AGENTS. THE CONTRACTOR IS INFORMEO THAT NEITHER IHE <br />FTRESENCE OFOUR FIELD REPRESENTATIVE NOR THE OBSERVANON AND TESTING BY OUR FIRM SIIATL EXCUSETHE CONTRACTOR IN ANY WAY OF DEFECIS OISCO\EREO IN THE <br />CONTFAC1ORS WOFX, IT IS UNOERSTOOO THAT OUR FIRM \/YILL NOT BE RESPONSIELE FOR JOB OR SITE SAFETYONTHIS PROJECI, <br />CERTIFICATION OF COMPLIANCE <br />I HEREBY CERTIFY THAI I HAVE INSPECTEO TO THE BESI OF MY KNOWLEDGE AI.t <br />OTHE RWSE NOTED. I HAVE FOUNO THIS <br />SPECIFICATIONS AND APPLICABLE <br />RC 8012943 ICC <br />City of Santa AnaBuildino Depa.hent 1918 W. Glenwood Pl <br />On File <br />Treeium, lnc. <br />Su tcont-aclor Engineer <br />lnspeclo(s) Name l/ario Cordero <br />T <br />TI <br />TYPE OF SAMPLE SLUMP OUANTITY IN SET ADDITIONAL REMARKS ON SAMPLESIII <br />TIME IN TITIE OUT REG,HOURS O.T, HOURS IRAVEL TIIIE <br />4II IIE <br />NO <br />INSPECTOR <br />AGENCY <br />All hspedjons bes6d on a mintnum of 4 hou6 and over 4 hours . 8 hours <br />minimum. in addi{on anyinspection Bnending passed noonwillbe an 8 hourminim{fit <br />Overtime b ling aier 0. Hou6 aM Satuft/s at Trrne and a Halt Sundays oouble Time. <br />P.O. Box 63304 <br />Los Angeles, CA 90063 <br />Tel: (800) 79'l -2136 <br />Fax: (888) 808-1317 <br />24 Hrs.: (310) 930-5515 <br />otfice@nationallab.us <br />Addition/Remodel <br />trtr <br />PAGE 1 or ICONTINUED ON NEXT PAGE