05-0257Corporate: San Diego/Imperial County: Inland Emgl;
2992 E. La Palma Z6 e. A 7313 Carroll Road, Suite G 14320 Elswortli Street, Ste. C101
Anaheim, CA. -'92806 San Diego, CA 92121 Moreno Valley, CA 92553
Tel: 714.632.2999 Tel: 858.537.3999 Tel: 951.653.4999
Fax: 714.632.2974 Fax: 858.537:3990 Fax: 951.653.4666
FIELD REPORT.
TYPE OF WORK ;p INSPECTOR ❑ TECHNICIAN
AVAILABLE: SOIL REPORT (Y) (N). SPECS 4Y) (N)
AIC-1 S l°
APPROVED PLANS (N) APPROVED SHOP DRAWING (Y') (N)
ARCHITECTFOR
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WEEK ENDING
PROJECT. NO.
311
EN�GIINEER
77
REP RT NO. PG OF
CONTRACTOR
PLAN FILE N0. +t?
PERMIT NO.
SUB -CONTRACTOR
PROJECT NAME
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INSPECTION ADDRESS
ADDRESS OF PROJECT
REPORTING REQUIREMENTS: IC90 FIELD INSPECTION MANUAUMTGL SOIL MANUAL - REVIEW PREVIOUS REPORTS AND LISTS''
IF THERE IS NON -CONFORMING WORK AT THE END OF THE WORK DAY, OR MISSING
MTRS, AND RFIS, ETC., FILL OUT AND ATTACH A DEFICIENCY REPORT
WHEN A DEFICIENCY,YOURS ORA PREVIOUS.INSPECTOR'S, IS CORRECTED; SO NOTE ON THE ORIGINAL DEFICIENCY REPORT AND
SUBMIT A COPY WITH YOUR WEEK'S. REPORTS.
MATERIALS,USED, _BY CONTRACTOR (INCLUDE RESEARCH REPORT NO. OR MATERIAL TEST REPORTS):
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CONTRACTORS EQUIPMENT,/ MANPOWER USED:
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AREA, GRID LINES, PIECES OBSERVED:
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STRUCTURAL NOTES, DETAIL, OR RFIS USED:
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REMARKS. INCLUDING MEETINGS:
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REWORK AS PERCENT OF ALL WORK TODAY'
PERCENT PRn.�IEOCOMPi ETION•
WEATHER:
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SAMPLESTAKEN:
TEMPERATURE: ' O
TESTS REQUIRED:
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SITE TIME START: .rSITE TIME FINISH: Z ;!:50
LUNCH PERIOD: -"" TRAVEL TIME: —C�" VERIFIEDIBY:
I DO CERTIFY THAT I HAVE PERSONALLY OBSERVED ALL OF THE WORK LISTED ABOVE AND THAT THIS WORK COMPLIES WITH THE SOIL INVESTIGATION RECOMMENDATIONS,
AND / OR THEaAPPROVED PLANS, SPECIFICATIONS AND APPLICABLE SECTION OF THE BUILDING CODE, UNLESS OTHERWISE NOTED IN THE DEFICIENCY REPORT
gnature Date of Report ICBO Certification Number
Print Name City / County Certification Number
Rev: 7/97
Inland EmpI.
11 ,
14320 Elsworth Street, Ste. C101
Moreno Valley, CA 92553
Tel: 951.653.4999
Fax: 951.653.4666
FIELD REPORT --
TYPE OF WORK XINSPECTOR O TECHNICIAN
AVAILABLE: SOIL REPORT (Y) (N) SPECS tfi)(N)
Corporate:
San Diego/imperial County:
2992 E: La Palma Ave., Ste. A
7313 Carroll Road; Suite G
Anaheim, CA 92806
San Diego, CA 92121
Tel:. 714.632.2999
Tel: 858.537.3999
-SSS'.
Fax:" .714.632.2974
Fax: 858.537.3990
Inland EmpI.
11 ,
14320 Elsworth Street, Ste. C101
Moreno Valley, CA 92553
Tel: 951.653.4999
Fax: 951.653.4666
FIELD REPORT --
TYPE OF WORK XINSPECTOR O TECHNICIAN
AVAILABLE: SOIL REPORT (Y) (N) SPECS tfi)(N)
APPROVED PLANSI Y�(N) APPROVED SHOP DRAWING (Y) (N)
ARCHITECT
FOR WEEK ENDING
PROJECT. NO.
S ', �� �•
% C3 9_Z1
ENGINEER
REPORT NO. PG OF
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CONTRACTOR
PLAN FILE NO.
PERMIT NO.
V 01.0'..
SUB -CONTRACTOR
PROJECT NAME
INSPECTION ADDRESS
ADDRESS Of ROJECT �.
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REPORTING REQUIREMENTS: ICBO FIELD INSPECTION MANUAL/MTGL SOIL MANUAL— REVIEW PREVIOUS REPORTS AND LISTS f �`✓d/ ��
IFTHERE IS NON-CONFORMING:WORK AT THE END OF THE'WORK DAY, OR MISSING MTRS, AND RFIS, ETC., FILL OUT AND ATTACH A DEFICIENCY REPORT
,.WHEN A -DEFICIENCY, YOURS, ORA PREVIOUS INSPECTOR'SJS CORRECTED, SO NOTE ON THE ORIGINAL DEFICIENCY REPORT ANDY
SUBMIT COPY WITH YOUR WEEK'S REPORTS.
MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO. OR MATERIAL TEST REPORTS):
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CONTRACTORS EQUIPMENT/ MANPOWER USED:
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AREA, GRID LINES. PIECES OBSERVED:
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STRUCTURAL NOTES, DETAIL, OR RFIS USED:ro
REMARKS, INCLUDINGNEEUNGS:
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REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMP) FTIOW
WEATHER: C\.q a SAMPLES TAKEN: SQA y
TEMPERATURE: TESTS REQUIRED: �� ^
SITE TIME START:
LUNCH PERIOD:
SITE TIME FINISH:
TRAVEL TIME:
VERIFIED
I DO CERTIFY THAT I HAVE PERSONALLY OBSERVED ALL OF THE WORK LISTED ABOVE AND THAT THIS WORK COMPLIES WITH THE S01 INVESTIGATION RECOMMENDATIONS,
AND / OR THE APPROVED PLANS, SPECIFICATIONS AND APPLICABLE SECTION OF THE BUILDING CODE, UNLESS OTHERWISE NOTED IN THE DEFICIENCY REPORT
Signature Date of Report ICBO Certification Number
Print Name
City / County Certification Number
Rev: 7/97