9738 (SFD)P.O. BOX 1504 No. 9738
7&105 CALLE ESTADO
Building Eisenhower
Address LA QUINTA, CALIFORNIA 92253 f
Owner
Sterling Homes. BUILDING: TYPE CONST. OCC: GRP.
Address 7224 Trade St #205 JJ
A.P. Number ��l.'� � � `3 ` �G�l
City Zip �,.: Tel.
San Diego 921��3 693--8444 Legal Description Lot1,v Block 9% t) `
Contractor Project Description SF D
Lendel Corporation
Address
same
City Zip Tel.:
State Lic. City
& Classif. 83305.51 Lic. #. � � � Sq. Ft. 1 35 No. No. Dw.
Arch; Engr.,
Size Stories Units
.
Designer i3rbina SL Assoc. New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑
Address Tel.
637.4 A;;svi.1 fake Ave 469-3.368 Permit does not include block call or
City Zip State pool
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of,Chapter 9 (commencing with Section
7000) of Division 3'of the Business and Professions Code, and my license is in full force and
effect. f „ f
SIGNATURE DATE
OWNEWBUIL"DER DECLARATION
l,hereby affirm that 1 am exempt from the Contractors License Law for the following Estimated Valuation 89.880.80
� Cf [9I� �f A
reason: (Sec. 7031.5,Susiness and Professions Code: Any city or county which requires a S9 • 880.80
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of [1
Division 3 of (tie Business and Professions Code, or that. he. is exempt therefrom, and the basis Plan Chk..Dt; .. 250.00
for the alleged exemption. Any violation of. Section 7031.5 by 'any applicant for *a permit p •
subjects the'applicant to a civil penalty of not more than rive hundred dollars (5500). 1 Z.
13 I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 259.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who Const. 594.50
builds or improves thereon and who does such work himself or through his own employees, Mech. �`. rj �%
provided that' such improvements are not intended or offered for sale. If; however, the building
or Improvement is'sold within one year of completion, the owner-builder will have the burden Electrical 127. �, $
of proving that he did not build or Improve for the purpose of sale.)'
O I, as' owner of,the property, am exclusively contracting with licensed contractors to coo- Plumbing 166. 50.
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law. _
does not apply to an owner of property-who builds or improves thereon, and who contracts for S.M.I. 9.00
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
0. I am exempt under Sec. B. t: P.C..for this reason Grading 20.00
Driveway Enc. 20.00
Date Owner Infrastructure . 1984.07
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to'self-insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof..(Sec. 3800, Labor Code.)
Policy No. CompanyC,. "t/ v.,
*C1YGropy is filed with the city. ❑ Certified copy is hereby furnished.
``. TOTAL J 3472.87 1 3222.87
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit Is for one hundred dollars (5100) valuation (i LS fir? Q3;f?115..4 7-}`}j •� ' _ �)
or less.) l.LY Ls-)°YY( 3 i' P i3f_ € .3c.e:. ♦Y e
I certify that in the performance of ihp work for which this permit is issued, I shall not
employ any
Califperson in any manner so as to become subject to the Workers' Compensation
Laws of ornia
Date Owner
NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked. -
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line
Lenders Name
Lender's Address FINAL DATE INSPECTOR
This isa building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that 1 have read this application and state that the above information is correct. Issued by: Date Permit
-
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above,
mentioned property for inspection purposes. Validated by:
Signature of applicant Date'
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO. FT. 0 $
UNITS
ROUGH PLUMB. BONDING
2ND FL SO. FT.
STORAGE TANK
YARD SPKLR SYSTEM
SENEA-6R SEPTIC TANK ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH) METER LOOP
HEATING (FINAL)
GAR. SO. FT. 0
POWER OUTLET
ROOF DRAINS
GROUT
DRAINAGE PIPING
CAR P. SO. FT. 0
BOND BEAM
WALL SO. FT. 0
GRADING
cu. yd.
$ -Plus-X$-=$
DRINKING FOUNTAIN.
SO FT 0
FRAMING /
URINAL
ESTIMATED CONSTRUCTION VALUATION $
O•�Z�.
WATER PIPING
NOTE Not to be used as property tax valuation
VENTILATION
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT. 0 c
BATH TUB
SO. FT. 0 c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID 0 11/4 c
SEWAGE DISPOSAL
CERT. OCC.
SO.FT.GAR 0 3/ac
HOUSE SEWER
FENCE FINAL
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK a
GROUND PLUMBING 00, 7aRGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE /
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SENEA-6R SEPTIC TANK ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL /
GAS (FINAL) TEMP. POLE 7 ��
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP.
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR.
FRAMING /
ROOFING �� 9/
n/^ y / l
G
/G//� , V ,V� �/�%��l�l./C/����E.'" "_ `
p
A
0
O•�Z�.
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING f -O /v
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION- �.
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
T -VY 4 4 Qakm
'1 P.O. BOX 1504 APPLICATION ONLY
Building S / 6SD E �S�N ��WE(Z 0� LA QUINT
Address A, CALIFORNIA 92253
Owner
Sle!(Z,L.10G �o�ES �7
Mailing BUILDING: TYPE CONST. R OCC. GRP.
Address
�aa,0 TttPOC s-� . S�,�E doS A.P. Number —)3— J3S- or) -1
City Zip Tel. OT 1 � UbcK � � 4 V 1� ) a
SAt� �� Go °�al a) G53' ��`iL} Legal Description
actor
Co trS NGL f; f)Rmi
�CN �,L CDRPe�L�10�1 Project Description �
SA J4�ZE �w
a p�EGo
zl ala
T�3_byy`�
State Lic.(�
& Classif. V 33 t3 SS 1
City
Lic. #
Sq. Ft. (
No. No. Dw.
Size �� 3
Stories Units
Arch., Engr
Designer . \Nv � `,
NewX Add ❑
Alter ❑ Repair ❑ Demolition ❑
Abress 3�
Tel.
City P�C6�
Z a,�a�
�i�t# C 1333.3
LICENSED CONTRAC S DECLARATION
I herebykfat I am licensed ��Cwa,ofChapter 9 (commencing with Section
7000) of of the Business and my license is in full force and
effect. •) 2 • 4
GNATU DATE
OWNER -BUILD R DECLARATION
I ereby affirm that I am exempt from the Contractor's License Law for the following
teas : (Sec. 7031.S,Business and Professions Code: Any city or county which requires a
pe t to construct, alter, Improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars (5500).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building
or Improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
Estimated Valuation
\
OO�• OV.
PERMIT
AMOUNT
Plan Chk. Dep.
% ...5
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
C 1 am exempt under Sec. B. & P.C. for this reason
S.M,I.
Grading
Driveway Enc.
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company .
❑ Copy is filed with the city. C Certified copy is hereby furnished.
TOTAL
%S
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(This section need not be completed if the permit is for one hundred dollars (S100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions or the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
ZONE: BY'
Minimum Setback Distances:
Front Setback from Center Line
_
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Side Setback from Property Line
Lender's Name
FINAL DATE
Issued by:
Validated by:
INSPECTOR
Date Permit
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-
bove
men,
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
in
;M
1-1144 -1It �At
� .
r�
of
Y 'Cu
Tit�r of 14a(ouinta
jluitbtn�- rznd`�5�''aiet� 34t*11t*,!mVn
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
BUILDING ADDRESS
51-650 Eisenhower Drive
Use Classification SFD Bldg. Permit No. 9738
Group R3 Type Construction VN Fre Zone Use Zone SR
Owner of Building Sterling Homes. Address 7220 Trade St #205
City San Diego, CA 92121 By; Lonnie Day
#t7rt7 e Dote: 4/1/92
Building Official
POST IN A CONSPICUOUS PLACE
It .
.REMRoING REQUESTED BY
MAIL T Y AOLMENT lu
WHEN REC(jupelr MAIL In
STERLING HOMFS
7220 Trade Street 11205
Ilym San Diego, Calif. 92121
Ixlt L
r
uklILA Nr1 02061.42
rsc eow NU. 2832 -SI)
7
J
SPACE ABOVE RECORDER'S USE ONLY
GRANT DEED (INDIVIDUAL)
The undersigned granlur(s) declare(s): .
Documentary transfer tax is S •3 J�40
( ) Computed on full value of properly conveyed, or
{ ) Computed on full value less value of liens and encumbrances remaining at time of sale.
( X ) Unincorporated area ( ) Cit of
Tax Parcel No. _173-135-(07-3 and 77�-� -
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged;
FSDRII TRUST DATED NOVEMBER 19,. 1,984
hereby GRANT(S) to
STERLING HOMES, a California General Partnership
the following described real property in the
County of Riverside
State of California:
Lots IS and 19 in Block 114 of Unit No. 12 of Santa Carmelita at Vale La Quinta,
as sho0h by Map on file in Book 18,Page 80 of Maps, in the office of the County
Recorder of Riverside County.
Dated June 3, 1991
STATE Of eA"tzQkb1W NEVADA
County of ,._ CLARK )J
FSDRH TRUSS' DATED NOVEMBER 19. 1984
BY/"', i� _
�-Imb SASS, TRUSTEE
On this fourth. ^ day of lune 19 91 , hcfnre me, Ilse undersigned, a Notary Public in and for
said County and Slate, personally appeared FRL'U SASS
personally known to me (or proved to me on the basis of satisfactory evidence) to be lite person .... whose name ___..18
subscribed to the within instrument and acknowacdged that he _ ..... •-_.� executed the samie.
WUNII�6��,.Iy hand and official a al.. -i
Notary Public in and fur s d County and State,
w460 -r.
Notary Publle•btalu tlt Nevada
( COUNTY OF GLARK I
SANDHA IIIANCO
I My CornmI36iun Expires I
( Nov. B. 1999 M _ « r
trrMw-w-M....-- M
(Nulary Seal)
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COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH ANNNOM ftrcWNa
ENVIRONMENTAL SERVICES DIVISION 1773-13.5 - 00 -7
PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM
Applicant: Submit this form with four copies of a scaled plot plan (1-20 scale) drawn to County speculations as Indicated on the attached check IIsL
A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of
Riverside. Approval of this application shall remain valid for a period not to exceed one year from date of approval.
VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG #
Agent, C�,ontr. orf, contact /^ _ ! p �} L < {
,Phone Address &Firm V D ICid �7
3.S/i
PhoneOwMailing Address ,f#J DYC6q
�8AC>&_ s%• I_
7Z2.0T S..", C- s'
City
State
Zip
Job Property Address
Legal Description Prop. (PM. Tract Lot)
L1i Vt TA
CIS)
qzz 5f
$ /G ,� o E! S�Nflo��<
/� Lai / �' �3 f_K_ 114
Lot SiFe
WaterAgency/Well
Use of Permit P/P, CU, etc.
Other
f{
<-U i �� /f /
C t1 W1
�elling,H
'X
Site Prep, etc.
tl /
I VL s
Signature Applicant ' Y• ' '
Oats
1 CATEGORY: REV CODE FEE
CATEGORY: REV CODE FEE
�K SUBSURFACE DISPOSAL 1238 $
❑ SITE EVALUATION UPON REQUEST 7349 $ 43.00
❑ MULTIPLE PARCELS WITHIN SAME 5 0.00
(NO PLOT PLAN)
LAUD DMSION
❑ SEWER/SEPTIC VERIFICATION 7348 $ 17.00
a 1 at 4 Parcels (Each) 1238 $ 57.00
(Less than 1 year)
b. Each Parcel after 4 7344 $ 24.00
❑ PRELIMINARY ELECTIVE 7352 $ 23.00
❑ Rereview (2nd review same parcel) 7344 $ 24.00
EVALUATION (Attach DOH SAN 53)
❑ Site Evaluation in Conjunction with
❑ HOLDING TANK 7351 $ 47.00
Critical Area 7348 $111.00
❑ ALTERNATIVE/EXPERIMENTAL 7345 $222.00
❑ Site Evaluation Lot Less than
SYSTEM
10,000 Sq. Ft. 7347 $ 87.00
,
INITIAL DATE
Holding Tank Agreements Completed ❑ Yes No
Certification of Existing S.D. System Required ❑ Yes l7 No
WOCB Clearance required. (Attach Form ❑ Yes + No '
DOH SAN 007, Santa Ana Region Only)
Solis Percolation Report Required. ❑ Yes No
Special Feasibility Boring Report Required. ❑ Yes Ill No
Detalled Contour Plot Plans Required (1 to 5 ft interval) ❑ Yes No
1
Other ❑ Yes No
Staff Specialist Lot Inspection Required ❑ Yes D No
Lot Inspection Date
'''
Solis boring report by d' f r Project it outs
Soils Map Page Soll Type Approved by Dame
No. of Systems
Type of System(s)
No. Dwelling Units
(1) Septic Tank
Soil Rate
Grease/Sand
❑�Ing Tank ❑❑ Existing
� Replecernerit
Bedrooms, Fixture Units
7 r / z/
7C'r /!I
Greese Inipp �
�pp
Cid
(2) Leach Line sq. FL
Sidevvall allowance
Install Line(s) "- fL long it wide with
Leach Bad sq�ft
Bottom trench area
JLrock/, sq, f<
•: -
min. inches rock below drelnl'rnes or
of=baRtcm area
_,.,,,.,..
,aper run ing ft
0 NA
Leachlines/bed special design for slope:
(3) Pit Diameter
No. Pits.
Pit Below
Seepage Depth
r.
Other.
Applicable
Inlet (Bi)
(TD)
Max. AI Sle Depth
N/A K Overburden factor
5 [ 6
/
No. 2 System
�v
REMARKS:
This application isAPPROVED/DENIED for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompan pllgt�pdn, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the
above -designed system. No constriction is permitted in the required reserved 100% expansion area.
Septic tank and sewer lines must be 50' minimum from any wells
`(1)
Leach lines must be 100' minimum from any wells, including expansion area
(3) Seepage pits must be 150' minimum from any wells, ncludiin/ng expansion area ! "�
Si nature of Health 6fficial/bfs1,Kr ;�✓SAF �, Date
RECEIPT NO. Issued By 70 c_ I? K Date 0/
DISTRICT: ❑ .Riverside, ❑ ` Indio ❑ Hemet ❑" Perris ❑ Rancho Calif. ❑ Blythe
/L/
92-17-1
DOH -SAN -122 (Rev. 3/90)DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. DepL' GOLDENROD - Plans/Reoords _ -
CALVIN C. KAMINSKAS
Assistant Commissioner
(714) 275.3000
OFFICE OF
AGRICULTURAL COMMISSIONER
JAMES O. WALLACE, Commissioner
83-612 Avenue 45 Suite 7
Indio, CA 92201
(619) 342-8291
DAN RILEY
Sealer, Weights & Measures
(714) 275.3030
DATE L' 12- -_-L-/ CASE NO. PC C 3 l02 cT
DEVELOPER'S NAME- V
ADDRESS: -2 a Q A Q S� S �_, �� a d S
TELEPHONE: 693
Dear Developer:
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ from plant material listed, this office must be notified
immediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
l
Agricult 1 Commissioner's Office
cc:'Indio and Riverside
4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 — FAX (714) 275-3012
(SIM Buena Engineers, Inc.
llOF
79-811 B Country Club Drive
Bermuda Dunes, CA 92201 - (619) 345-1588
Client Name_
Client Address
Client Phone
DATE
7-19-171
TEST LOCATION
-6-14, 3D
JOB NO.
PROJECT
FIELD TESTING
LOCATION
REFERENCE CURVE
CONTRA TOR
al
DRY
DENSITY
IbsJCu. R
OWNER
WEATHER
TEMP. o at AM
C at PM
PRESENT AT SITE
TEST
NUMBER
TEST LOCATION
-6-14, 3D
LOT
NO. ELEVATION
FIELD TESTING
REFERENCE CURVE
MOISTURE
CONTENT
%.
DRY
DENSITY
IbsJCu. R
MAXIMUM
DRY
DENSITY
%.
MAXIMUM
DRY
DENSITY
Ibslcu. tL
OPTIMUM
MOISTURE
CONTENT
%.
11S.o
�
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9
rio
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'�-11 So
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NZ
REMARKS: +akL
a CL # 14flUU�.
Cf kd
FIELD REPORT
CLIENT REPRESENTATIVE SIGNATURE TECHNICIANS SIGNATURE 7974.
Buena Engineers, Inc.
. �z
79-811 B Country Club Drive
Bermuda Dunes, CA 92201 • (619) 345-1588
Client Name
Client
Client Phone
ATE
TEST LOCATION
JOB NO.
PROJECT
FIELD TESTING
LOCATION
REFERENCE CURVE
MOISTURE
CONTENT
%.
CONTRACTOR
G✓I- r
,t
OWNER
WEATHER
C (- 4
TEMP.
�'j U
o at AM
° at PM
PRESENT AT SITE
TEST
NUMBER
TEST LOCATION
LOT
NO.
ELEVATION
FIELD TESTING
REFERENCE CURVE
MOISTURE
CONTENT
%.
DRY
DENSITY
Ibs./Cu. tL
MAXIMUM
DRY
DENSITY
%,
MAXIMUM
DRY
DENSITY
Ibs./cu. ft.
OPTIMUM
MOISTURE
CONTENT
%
5;) `
91,
93
EY IJ,- 9F
V 14 c A
E
rCiJSF
✓/fi r.
r
sa- �Su
a- �FiG
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s F_
/-�cl. c••�
G —
REMARKS: %)�4 F /moi 6- J �� -�E S TS
/1�� /��y,: r
CLIENT REPRESENTATIVE SIGNATURE
FIELD REPORT
TECHNICIANS SIGNATURE 3689