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ICS Ixspncrron Consurrmc SrRucBs <br />Scnla g S o uthc nt Califu nia <br />INSPECTION BEPORT <br />PO. Bor 2M7 . West Covina, CA 9L793'2047 <br />Photc 62A 9264236 <br />icsi$Pectio]l@Yahoo.com <br />Hours <br />REGULAB 1.5 X 2X <br />,(-4-o-Erp€nses <br />O neh,lorce,nenr <br />- <br />E concrae <br />- <br />O uaso.ny <br />- <br />O Plestrer.r Poet Ten <br />- <br />0 rteproofrrg <br />- <br />&/s-tucarnr srecr <br />- <br />EfEpoxv 0 or.. <br />Dolcdptlon ol Work ln3poct.d <br />t ,\LSi-f+LLhTr6p bF '' 2" '/2" ft+cE & Eg s 12-c,el 6 1a1 I rx 8" € )'!g6,i) <br />Fo rr \1J A-.-L -f r 6s T 1^36P e< €Por c-- <br />11--1 z l-e s-6?f-D Ztfi FL-.>az- €4-€-t tr-r r-ft Lt a.a 1.8 Lt n€s <br />Lt a€ l.'z- Lr €<-< - c,L ee-L 5szar i.J 5 !-e-L( F C \o.J oF 5 R€ rZ t+a- DG)\,^.6L-3, \,./ r ihr 1o" i413cr> <br />\P rrll 5 sodSe<-*PE T-c-<- z<6?) tlrfo LrF( s<-\ ^ <br />{-o o<(o err-<Lt.-16 Lrne t.f <br />Spsclmens <br />Certilication of Compliance <br />I declare undar penalty ot pedury that all ol lhe above stat€ments <br />are trus, and that ol own p€rsonal knowlodga lhat the work <br />during the period covered by this report has been P€r{ormed <br />and installed in every material Iespsct in comPlianc€ with ths <br />approv6d plans, specilicalions and all aPplicabls codes <br />All lnspoction bas6d on a mlnimum ol 4 hours and over 4 <br />hours - 8 hour minimum. ln addition, any lnspoction extending <br />past noon will be an 8 hour minimum. ll lnspector is called to <br />a proiect and no work perlormed, a 2 hour minimum will be <br />applied. <br />lnspector t c.+ t+E .- E , e-Da 'L_<*Approved /Authorized by: <br />lnspec{or Signature (Project Sup6rintendent) <br />(lnspsclion Constilting SeNices) <br />Page: <br />- <br />e1 <br />It/l ' Cr'r tt 1. zv.t?T <br />"a+' <br />s s <br />€o | (a€L-Ut kfi fiurue(t,.,9 *i*i'{-{igE+"*'XrrlE Jat.\_t Er <br />ro{ €*st 41t sf (: Iv\ \,, <br />-J Ac 'LA,bgsTcEt <br />REOUIREMEMIS: Limlt bl gne lob numb.( one p6nnh numb.r por Bh€ot. ld€ntily sll work by typ€ lnd SPECIFIC locatlon, <br />Non-Cornplionl work mu3t b€ spocscally ldorilifi6d. Co.nrnunlcaUon (RFl Sk.ti ; ctc.) roldi.E F.virir. hontompll.nl ilcms musl b6 lisled <br />Recotd co.fl.tsalgos snd cor nrlhauons with Folocl d66lgn 13. hrilding Bnd p€mil granling a'nho.ity oltidals. <br />Oesign PSI Cublc Yards <br />lnspeclor lD's loB.Lt{ 1€ 7-c-c-Submitted By: <br />Scanned with CamScanner <br />Mileage: <br />o <br />Mix Used