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.t Southwest Inspection and Testing, Inc.
10826 South Norwalk Blvd., Santa Fe Springs, CA 90670
(562) 941-2990 - (714) 526-8441 • Fax (562) 946-0026
REGISTERED INSPECTORS'S DAILY REPORT
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TYPE OF ❑ Reinforced Concrete ❑ Strdc' Lural Steel Assembly ❑ Quality Control
INSPECTION ❑ Post Tensioned Concrete ❑ Fire Proofing - ❑ Other
REQUIRED^❑ Reinforced Masonry ❑ Asphalt
Job Address f / .- 1 S S�6! �- P City
Job Nome
Issued.�Y��_/
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Type of Structure >� ii��r
Architect
Material Description (type, grade, source) �.
Engineer p
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Contractor e N 4
Inspector(s) Nome A ,
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Subcontractor N 0,
TESTS PERFORMED
TYPE OF SAMPLE
SLUMP
QUANTITY IN SET
ADDITIONAL REMARKS ON SAMPLES
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INSPECTION SUMMARY — LOCATIONS OF WORK INSPECTED, TEST SAMPLES TAKEN, WORK REJECTED, JOB PROBLEMS, PROGRESS, REMARKS, ETC.
INCLUDES INFORMATION ABOUT - AMOUNTS OF MATERIAL PLACED OR WORK PERFORMED, NUMBER, TYPE & IDENT. NO'S OF
TEST SAMPLES TAKEN: STRUCT. CONNECTIONS (WELD MADE H.T. BOLTS TORQUED) CHECKED, ETC.
7 B Va -- e7 d
CERTIFICATION OF COMPLIANCE CONTINUED ON NEXT PAGE ❑ PAGE OF
IHEREBY CERTIFYTHATIHAVE OERVEDTOTHE BEST OFMYKNOWLEDGE ALL OFTHE ABOVE REPORT ED TIME IN TIME OUT REG. HOURS O.T. HOURS CYLINDERS
WORK UNLESS OTHERWISE ED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS,
SPECIFICATIONS, AND AP ABLE SECTIONS OF THE ftpVERN1 UILDIiyG LAWS.
All inspections based on a minimum of 4 hours and over 4 hours - 8 hour
e �/ minimum. In addition, any inspection extending past noon hour will be an 8
"FT
jREGI D INhour minimum.
dSPECTOR �
Approved by
TY NO. AGENCY 11 Project Superintendent
WHITE - OFFICE COPY, CANARY - ACCOUNTING COPY, PINK - INSPECTOR'S COPY, GOLDENROD - 10B SITE COPY