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h, UgY,,*l:-?i/aso, Dresden crrcre <br />Hunlrngton B8ach, CA 92647 <br />Ollice 714-943-277 7 Fax 714-892-5829 <br />REGISTERED INSPECTOR'S REPORT <br />TYpF oF l-lRcrntorceo concrcrc <br />'*sii1o* f]eosr rcnrron concrcrc <br />REo,TRED Hl,ilj::::,H::" <br />Job Address: 1801 N. Linwood Ave <br />rob N'mo Cirev nes. Rm Addition <br />Typ6 o[ Structuro: <br />Mstori.l D63cripion (typo. grade. sourco): <br />Job No D.t 7_i3-15 Tlrt|a <br />CorllrolEhtructurll S16.l As3.hbty Ehrrlty <br />Lf',. Proorns lIJEpo,vI lAlDhslr ]-,,lncU.ll_I 8ar c.,r,ns3 uou'cr <br />clty: Santa Ana <br />Ponnit #: 10184533 tsruod By, Santa Ana <br />A.chitgct: <br />Enginesr: HanS Christian HanSOn <br />Contrsclor: OWner BUildef <br />Bill To: <br />lnspoctoB (s) Nam6: JOn NeWSOm <br />Subconkactor: <br />Contact 'nro: Toby @ 714-335-9233 <br />TYPE OF SAMPLE SLUMP <br />TEST PERFORMED <br />OUANTITY IN SET AOOITIONAL REMARKS ON SAMPLES <br />INSPECTION SUMMARY .LOCAIIOII OF WOFX II{SP€CTEO, TESI SA'IPIES IMEN,9/OiK RE,JECTEO, JOO PROBLEMA. PNOGRESS RET'AEG, EIC <br />rxcr,uo€s rNFoRnaTlox Alot r AlbuNr oF gaYEFrar Pr.ac€o oR {woex P€RFoRraEo. NUIIBER, IYPE t roEtnFrc rl<N <br />NOS Of rESr Slra4ES rAXEX STRUCTUEA! Coillr€Ctors (WELO ra D€. r{ S to(ts tOeOUE)CX€CXEO, ErC <br />CERTIFICATE OF COMPLIAiICE <br />TIME IN T]ME OIJI <br />PAG€ <br />REG HOURS SAMPLES <br />BUIL 10:00 12:00 4 <br />ArL [I3P6CTrOXS lrsEo OX A UtNDaUv Of a T.OURS AXO OVER a HOUR9{,+IOIJR <br />rlrl$rucs lrl ADorrror. AiY [tsPEcTroN Exrtraorxc p^sr rx[ noor Houi wtl-t <br />B€ AX ' aOUR Ullrus <br />RE GIgiE AE O INSPECIOR <br />1036034 ICCR/C <br />A6ENCY <br />,**t/,--a/,7."k"* <br />Observed the installation ol epoxy dowels into existing footings using Simpson xp epoxy, <br />expiration 2016. Verified the hole depths and proper cleaning with nylon brush and comressed <br />air prior epoxy. Schedule on sheet S-1 . <br />Detail on S-3 / D = Used (2) #4's Top and Bot at footing connections ( two locations). <br />Work is according to approved plan. <br />--a