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Type o, <br />lnspection <br />tr <br />tr <br />tr <br />Welding / HS Bolting <br />Rebar Placement <br />Rebar Welding <br />n <br />tr <br />tr <br />Reinforced Concrete <br />Fireproofing <br />Reinforcod Masonry <br />tr <br />Fu <br />Shotcrete <br />Epory / DIA <br />Other <br />Proiect Name:stJtTE 30-0 AND 500 T tO eemit* 1O110012 <br />Jurisdiction:Address: 106 W 4TH ST.. SANTAANA SANTAANA <br />Architect:contractor: VISIONEERING STUDIOS <br />Ensineer: GOUVIS Subcontractor: <br />Type of Sample:No. of Samples: <br />Welde/s Cert.'s. etc. <br />/rVSPECfr0r{,qEPORf <br />Dato: 7129119 <br />PLACEM NTO 4 o <br />CONCRETE 3RD L L o F PER MD AND , THREADED RODS AT <br />FTOP C 2.2 SIM e N XP EPCXY ICC 2508, ALL HOLES <br />BLOWN AND BRUSHED CLEAN PRIOR TO PLACEMENT PER MANUFACTURER <br />INSTRUCTIONS. <br />I h.roby ao.tify that I havo ln8poatdd to thc bart of my knowlgdg. rll the.bovo repoiod wo.k uhls.r otherwiao noicd. <br />I h.v. round thl. worf to comply wlth tho approvod pl.nr, spaclflc.tlors .nd applicablc roctlont otthe govornlng bulldlng code6 <br />lnspector's Slgnature h{4w All insp€ctions ba6od <br />on l minimum of 4 hrs. 8nd <br />over 4 h.a. ia an 8 hr, mlnlmum <br />Print Namc CRYSTAT- LEFF R6g. T!me Over Time DBL. Time <br />certllication rypJCC REIN CONC <br />certtflcation tru.uu, ICC 5028455 Approvod 8y <br />pqctio <br />I <br />port <br />: <br />trns B,en <br />I <br />,t. <br />I