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07120161 SI SIGNET Testing Labs, Inc. FILE DATE: ce, DSA FILEIAPPL. NO. PROJECT NO. K.Iz; -Z) 5Cp 34-2 OSHPD NO. PROJECT: '/) I A-r�9t7QQ ?4 lI r$ 76 PERMIT NO. C t M7 QI6,)I LOCATION: c 01 ) ��1 WEATHER: CL � TEMP: .©'REBAR ❑ TENDON ❑ TENDON STRESSING is Inspected the placement oft REINFORCING STEEL,/TEN DONS,-/AB'S/HD'S/TIE DOWNS for the following location: o a-. ❑ Observed post-tensioning operations, measured and recorded elongations of tendons for the following location: V' CONCRETE ',g,--CIP ❑ PC -❑ PT ❑ SHOTCRETE' ❑ NS GROUT ❑ Inspected the batch plant operations. Batch Plant/Location: Observed placementrof-CONCRETE SHOTCRETE/NON-SHRINK GROUT at the following location: iE ❑ Cast—set(s)of compressive strength samples. . Mix# I r1 5%1 W p Total cu. yds. placed I N Slump(s): %Air: Unit wt(s): ❑ Show up/Stand by time. Job Canceled/ Delayed due to: I ❑ All non-compliance items were brought to the attention of: `/ ,\ -7 q /� �att+t/he job site. I NOTES: ( r�Q X l�_C Gf-L I ,��,,^ Y RUJ'T t / 7�IJV r7 f� C(xCy1T _(L-t C A7 —m&. ,-i�,(>iF L-Y AmM To the best of my knowledge, the abo a WAS 1 WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. ' r E3 Except As Noted Superintendent/Representative: Inspector/Technician: 3121 Diablo Avenue 1417 No. Market Blvd. #1 520 Mercantile Drive#A 1320 Simpson Circle j ` 7580Metropolitan Dr. #205 Hayward CA 94545 Sacramento CA 95834 Cotati CA 94931 Anaheim, CA 92806 �J I San Diego CA 92108 (510)887-8484 (916)568-5858 (707)-665-3950- (714)399-1500 t (619) 682-3820 JOB SITE COPY FORM#304(REV 01/08)