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Miscellaneous Field Test & Inspection Report 2013-5-24 (3)
r aT0 Professional Service Industries,Inc. © � Information Padl n.Cutter 7217 Suite 480 6032 N. OR 97217 .To Build On Phone:(503)289-1778 .6(2 — 3 Engineering • Consulting • Testing Fax:(503)289-1918 Special Inspection Daily Field Report Report No: SIDF:0654137-60 Issue No: 1 These test results apply only to the specific locations and malerials noted and may not Client: WAL-MART STORES, INC. CC: represent any oilier locations or elevations.This rePon may nal berepmdufxl.ewp 2001 S E 10TH ST BLAKE JOHNSON,DAVID in lull,alhom written permission by Prolessunat Service Industries.Inc.If a wo wmpliance appears on this report.to the extent that the waned ranmmonance MAIL STOP 5570 NICHOLS, ERIC EVENSON, impactslno proien,theresomion is outside use PSI awpe of ergasement. BENTONVILLE, AR 72716-5570 KATYRYN JERKOVICH, ROB ERT CASTILE,WILSON r� HU Project:• WM 4178-00 SPRINGFIELD OR TO SPRINGFIELD, OR Approved Signatory: Deborah Priest(Special Project Manager) Date of Issue: 5282013 Gener I Details Date: 5/24/2013 General Contractor: S.D.Deacon Permits: 811-SPR2012-02370 Weather: Overcast with wind Type of Inspection Performed J Reinforced Concrete ❑Structural Masonry ID High Strength Bolting ❑ Fireproofing D Rein orcing Steel ❑ Soils ❑Welding ❑ Other C2 New Inspection C2 Re-Inspection Standby Time: • Field Observations & Comments SI Special Inspection 0 Continuous 51 Periodic Location(s)/Item(s): • 6" freezer topping slab @ grids B to 8.4 from 3.1 to3.9 (2) 16" x 16" x 1/2" embed plates Grids A 1 to A.5 from 2.4 to 2.6 (2) Truk dock leveler walls and surrounding S.O.G. #3's all 12" o.c. Reference Details/Drawings: S1/key r1ote#8 52/12,10 S2.1/1,14 Remarks: Dynasty Concrete Co., placed 25.75 yds of Knife River Mix ID #081-7RNE5300, 3500 psi structural concrete into the above described areas, all concrete placed was consolidated using hand held H/F vibrators. The first 20 yds (2 trucks) were placed using a pump truck and the last load (5 yds)was placed directly from the mix tuck into the arms. To the best of PSI's knowledge, the work inspected to the approved construction documents are: J Conforming ❑ Non-Conforming Inspector: Dale Russell Inspector Cert No.: ICC # 8005920 Jobsite Representative: Bob Garrison • ©2000-2013 OESTLab by SpeclraOEST.com Page 1 of 1