Mayes Concrete Cylinder RecordDAILY INSPECTION REPORT
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Report Number: � �
Service Date: 1 ( 2 2. C' 2 S Lynnwood, WA (425) 742-9360
Inspection Type:
Tacoma, WA (253) 584-3720
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Client Project ;
Engineer:
Architect:
Contractor:
Project Number: ''x'? -7
Permit Number: F`� t C
Weather:
COMMENTS
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SUMMARY
To the best of our knowledge, all items inspected as noted above were in general ❑ Yes ❑ Preliminary Observations.
Conformance with the approved plans and specification. 7 No L Deficiency Corrected — Report No.
Arrival: I Departure: - Travel Time: I Total:
SAMPLES OBTAINED (NUMBERtSIZEiTYPE)
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TERRACON FIELD REPRESENTATIVE REVIEWED BY
THIS REPORT IS CONSIDERED PRELIMINARY AND SUBJECT TO CHANGE PENDING REVIEW BY OUR PROJECT MANAGER.
FINALIZED FORM SHALL BE ISSUED WITH PROJECT MANAGER SIGNATURE.
This report is exclusively for the use of the client indicated above and shall not be reproduced except in full without the written consent of our company.
M7 10IR, 531-17