07-0824 Field ReportFA
Corporate:��
2992 E. La Palma "Ave. Ste. A
Anaheim, CA 92806
Tel: 714.632.2999
Fax: 714.632.2974
Dispatch: 800.491.2990
11
San Diego/Imperial Couri9
7313 Carroll Rd. Ste. G
San Diego, CA 92121
Tel:.,858.537.3999
Fax: 858.537.3990
Dispatch: 888.844.5060
FIELD REPORT
Inland Empire:
14467 Meridian Pkw., Bldg. 2-A
3 Riverside, CA 92518
Tel: 951.653.4999
Fax: 951.653.4666
Dispatch: 800.491.2990
TYPE O4F,IWORK/ I]�INSPECTOR ❑TECHNICIAN
AVAILABLE: SOIL REPORT (Y) (N) SPECS (Yj (N)
1_ /(
APPROVED PLANS.(Y) (N) APPROVED SHOP DRAWING (Y) (N)
ARCHITECTr ,r�
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FOR WEEK ENDING
PRO/JECT. NO.
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ENGINEER
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REPORT NO. PG OF
CONTRACTOR
PLAN FILE NO.
PERMIT NO. '
SUB -CONTRACTOR
PROJECT NAME
INSPECTION ADDRESS /A
ADDRESS OF PROJECT
A�
REPORTING REQUIREMENTS: ICBO 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 OR A PREVIOUS INSPECTOR'S, IS CORRECTED, SO NOTE ON THE ORIGINAL DEFICIENCY REPORT AND
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:
REMARKS, INIX UDING AIEETTNGS.
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REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPL ETIOW X
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WEATHER: ck ( SAMPLES TAKEN: \, \ �,� E ` i> X ( (7 C ( I-
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TEMPERATURE: �� TESTS REQUIRED:
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SITE TIME START: �, (•` SITE TIME FINISH:
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LUNCH PERIOD: TRAVEL TIME: VERIFIED BY.
I UU L:tH I IrY 1 HAI I HAVE PER�bUNALLY OBSERVED ALL OF THE WORK LISTED ABOVE AND THAT THIS WORK COMPLIES WITH THE SOIL INVESTIGATION RECOMMENDATIONS,
AND / OR THE APPROVED PLANS, SPECIFICATIONS AND APPLICABLE SECTION OF THE BUILDING CODE, UNLESS OTHERWISE NOTED IN THE DEFICIENCY REPORT
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Signature Lt%,�/ �"— — Date of Report ICBO Certification Number
Print Name ' City / County Certdication Number
Rev: 7/97
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P.0. BOX3800, CORONA, CA92878-3600 !
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Phone 00/8347557 SanDlErgo800/670-1220
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81 RIVERSIDE 6120
- 2 0 8 SUN CITY - 27050 WATSON RD.
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M2 MOAENO VALLEY - 128900 815 VERNON-LOS ANGELES - 3365 E. 26TH ST. 822 NO. HOLLYWOOD 13132 RAYMER STREET 029 EL CAJON - 2t5 CYPRESS LANE
f DAY ST, d 9 ARROWHEAD - 29150 HWY 18 N16 ANAHEIM - 201 E. COMMERCIAL ST. 623 PARAMOUNT 7277 E. ROSECAANS AVE. 030 CORONA -1540 SHERBORN STS
63 REDLANDS - 8353 ALABAMA ST 610 SANTA FE SPRGS - 12311 GAEENSTONE AVE.
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017 SANTA ANA - 310 N. TOWNSEND ST. i24 RIALTO - 2601 N. ALDER AVE. 031 NESPERIA - 9661 C AVENUE r
64 FOMANA - 13792 SLOVER AVE. .011 CABAZON • 13990 APACHE TRAIL. - 018 LAKE FOREST - 25931 TOWNE CENTRE DA: 625 GARDENA - 301 W. AOSECRANS AVE, 032 UPLAND _ 1975 N. BENSON f
65 POMONA - 2470 POMONA BLVD. 612 SAN BERNARDINO - 1955 W. -97H SL 819 AOELANTO - 12203 VIOLET RD. f62G THOUSAND'PALMS-72460
06 HEMET/SAN JACINT
VAANER ROAD 833 MIRAMAR- 5692 EASTGATE -0RWE
. - 1675 STATE SL 813 IA PASALEADENA
- 19631 LIVE OAK LANE 620 SAN CLEMENTE - 116 RINCON CL ,�^ 127 MUAAIETA • 26190 ADAMS AVE. N34 LUCERNE- 36555 HWY 18
07 BEAUMONT - 452 W. WIS ESTRADA AD. 014 PASADENA - 1420 N. LINCOLN AVE. 021 IRVINE - 16081 CONSTRUCTION CIA. WEST
028 OTAY MESA - 7961 AIRWAY ROAD. 635 BIG BEAR LAKE -- 42040 BIG BEAR BLVD.
{ PLANT DATE CUSTOMER NO: SOLD TO:
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TX CD DELIVERY ADDRESS & INSTRUCTIONS
L CUSTOMER P.O. / JOB OR LOT #
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ORDER NO. METER READING TIME TYPED TRUCK LIC NO.
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LOAD NO. SLUMP TRUCK DRIVER
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DRUM
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j TO JOB G REVS: Job -site Cylinder Test: ❑Yes
TIME ON JOB
MIN. CHECK #
'- 414" Water
ON JOB added on job at
%`,� Customer's request: STAND BY MIN. CHECK ❑
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START POUR AMOUNT BY
gals t0 Full Ld. RATE OF X $ PER MIN. CASH ❑
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FINISH BY
NISH POUR ' gals to 2/3 Ld.
$ PLANT MGR SIG
gals to 1/3 Ld.
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LEAVE JOB
ADJ. Meter ` 1,0"! � 4 min. per yd. unloading time allowed.
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ARRIVE PLANT Additional water added t..hls concrete .11 reduce its strength. Any Additional unloading time charged at current hourly truck rate
water added exceeding the design water is at the customer's own risk.
r'TERMS
AND CONDITIONS OF SALE
In consideration of Robertson's delivering the described materiel to a place designated by the Customer, the Customer hereby releases and agrees to indemnify and hold harmless Robertson's and
Its employees from all liability or claims for damage done by them, resulting from the movemenLof Robertson's vehicles upon or about the dell location.
Customer acknowledges that the described
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material has been chosen and selected solely by Customer without Robertson's having reviewed any plans or Specifications relating to the project on which
the material is to be used. Customer agrees to defend, indemnify, and hold Robertson's harmless from all liability or claims for damage relating to said material being Inappropriate, incompatible, Improper or
In event Roberts on's retains the seMcles of ora orneyygto colllleadt orconditionsthe e Is utilized,fullestpermitted
the land errials, fff
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the scribed atthe Customterial
eg ees pay tee s Incurred by Robertson's:
{ Customer agrees to pay a time price differential of 1'/x96 per month on any amounts owed to Robertson's
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for more then thirty (30) days.
LD QTY CUM QTY ORD QTY PROD CODE MIX AND COMMODITY UOM. UNIT PR
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WEIGHMASTER CERTIFICATE
THIS IS TO CERTIFY that the following described commodity was weighed,
measured, or counted by a weighmester; whose signature Is on this certificate,
who is a recognized authority of accuracy, as prescribed by Chapter 7
(commencing with Section 12700) of Division 5 of the California Business and
Professions Code, administered by the Division of Measurement Standards of the
California Department of Food and Agriculture.
!✓: ti • ROBERTSON'S !•'
WEIGHMASTER
BY DEPUTY
TAX
PREVIOUS
BALANCE
SUB
TOTAL
STAND BY
CHARGE
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