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ROB LANGNER INSPECTION SERVICES <br />_17L41M9237 <br />REGISTERED INSPECTOR'S DAILY REPORT <br />CERTIFICATION OF COMPLIANCE OF <br />I HEREBY CERTIFY TIIAT I TIAVE <br />ALL OF THE AAOVE REPORTED <br />FOUND THIS WORK TO COTPTY <br />AND APPTICABTE SECTION OF <br />SIGI{ATURE <br />Reinfiorced <br />Concrete <br />SPECIALTY <br />sm F{o2 <br />TO THE BEST OF MY KNOWLEDGE <br />OTHERWISE NOTED, I HAVE <br />E APPROVED PIINS, SPECIFICATION <br />ING BUITDING LAWS <br />TERED SPECTOR <br />11398ss <br />NO AGENCY <br />CONTINUED ON NEXT PAGE tr PAGE <br />TIME IN TIME OUT SAMPLES <br />12:00 PM 4:30 PM <br />Appmved By <br />Project Superintendenl <br />Offrce Copy o Canaty - Ac@unting bpy . Pink - lnspeclor's Copy . Goldentd - Jobsite Copy <br />SWIT Job No. <br />RL-001 <br />Dale <br />1-29-18 <br />TYPE OF <br />INSPECTION <br />REQUIRED <br />I Reinbrced conqete <br />D Post Tensioned Concrete <br />! Reinforced Masonry <br />! Sfuaurat Steel Assemuy <br />! Fire ermfing <br />fl Asphalt <br />EI Quality conlrcl <br />fl Wood Framing <br />X ourer Epoxy <br />Job Address 1834 West 2"d St. <br />City santa Ana <br />Job Name <br />Quy Tran and Hang Tran Permit No 20153981 lssued By Santa Ana <br />Type of Structure Burn out Duplex Architecl Charles Ian Blaugrund <br />Material Description (type, grade, source) <br />Simpson Set XP ICC-ESR # 2508 <br />Engineer <br />Contraclor Charles Mzi Consb'ution <br />lnspeclo/s Name Robert Langner Subcontractor <br />TESTS PERFORMED <br />TYPE OF SAiIPLE SLUMP QUANNTY IN SET AODITIONAL REMARKS ON SAIIIPLE <br />INSPECTK)N SU XARY _ LOCATIONS OF WORK INSPECTEO. TEST SAMPLES TAKEN, WORK REJECTED, JOB PROBLEMS, PROGRESS, <br />REMARKS. ETC INCLUDES INFORMATTON AaOUT - AMOUNTS OF iiTATERIAL PLACED OR WORK P€RFORMEO, NUMBER, TYPE & IDENT. No'S OF <br />TEST SAMPLES TAKEN STRUCT. CONNECTIONS (WELD iil,ADE H.T. BOLTS TOROUED) CHECKED. ETC <br />*** Observed drilling and clean out with hiqh presure air and brushing for epoxy Botts <br />and Hold Downs... 5/8" allthread... Anchor bolts 5" inbed... Holdowns 12" embed..,Then epoxy <br />with Simpson Set XP...ICC-ESR # 2508...Expiration Date 08/2019....A11 epory work according <br />to plans and specifications.....SD-1 Details (2) (3)..... Total anchor bolts (40) total hold downs (10) <br />@sotrttlsrcst Insoecflon a TcstirE, Ir!.. <br />S:\FORI'iSIDAILY REPO(T TEI'IPIATES a FORtIS\R.qffi In6p.dD/s Daily Repo.t Ternplat .dd <br />ICC