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HomeMy WebLinkAboutN2018-02584' cofNewport BpaBh 114 1 11111111111111111111111111111111111111111111111p1111 Permit No:N2018-025800%���ach, CA 92660 Permit Counter Phone (949)644-3311 Project No : 0813- 1 . Online Inspection Request - www.newportbeachea.gov / Online I`AN N E;) t•41dY11Yl'' Services Inspection Requests Phone (949)644-3255 Job Address : 2067 PORT BRISTOL CIR NB Thomas:Guide: 889H5 Description : CONSTRUCT 2 NEW DRIVEWAY APPROACHES PER STD 162-L, PLUG EXISTING APPROACH PER STD 165-L, 2 NEW CURB DRAINS PER STD 184-L, REPAIR SIDEWALK, CURB AND GUTTER PER STD'S. Parcel # : 4580-811-0 - Legal Desc : N TR 6623 LOT 22 fair Owner: TALON PARTNERS '+:� k �• ' Contractor: CHASE GENERAL ENGINEERING CONTRACTOR INC Phone: 949-345-1001 ' L' Phone: 714-914-6345 Address : 16520 BAKE PKWY, #105 Address : 15332 NEWCASTLE LANE IRVINE CA 92618 HUNTINGTON BEACH CA Applicant: CHASE GENERAL ENGINEERING CONTRACTOR INC Phone : 714-914-6345 [ Address : 15332 NEWCASTLE LANE HUNTINGTON BEACH CA Special Cond.: PRE -CONSTRUCTION MEETING REQUIRED Permit Processing Fee : $241.00 Sewer Connection : $0.00 Agreement Fee: $0.00 4TT Box Cover: $0.00 Traffic control Plan Check : $0.00 Total Water Meters : $0.00 Inspection Fee : $495.00 Water Meter Connection : $0.00 Refundable Deposit: $0.00 Total Water Meter Box: $0.00 Street Tree Fee : $0.00 Adjustment: $0.00 Processed By: Utilities Approval Traffic Approval : General Services Approval Contractor State Lic: 906147 License Expire: 11 30, 2019 Business License : BT30054273 Business Expire: 08 07, 2018 Workers' Compensation Insurance - - Carrier : STATE COMP INSURANCE Policy No: 9047185 W. C. Expire: 03 01, 2019 Total Fee $736.00 Paid : $736.00 Balance : $0.00 Receipt No: Date: _/_/ Other Department: Date Date : / / Permit Denied Date Date : / / Issued Permit: Date Date Z?I PROJECT ADDRESS: TAILED DESCRIPTION OF PROPOSED W RK: ST H a'iY kle� Cuv r' PPLICANT: L �' Phone• Email Address: Mailing Address: .107 — Ci ! ate2ip: OWNER: Phone: Email Address: Mailing Address: CitylState0p: :-'.ALL.00N RAGTOR INFOWAT OR —RE JLI kl, SE•44]_ ' ' . : . CONTRACTOR: Office Phone: Company (if different)• Jobsite Phone: Other Phone: Email Address: Mailing Address: City/State/Zip: State License Number & Class: City Business License Number: Ex p ices: Expi 7 WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code) Company: Policy No: 910 - Expires: 3 / 4 EF 1H4AF�l:E:DEP�'1S1T tMfORMi?►Tll?f : IfJF IiAa4i�::::::::::::::::::::::......::::::::::::::::::::::::: : : :::'::: ::: ::::::::.:::::::::::::::;:;::::::::::::....:::::::::::::::::::::::::;........;:...::..:..:.:.:.:.:.:.:.:.:.::.:.::: :::::=: : FletunisE Pa .ab ..o;........................... . ail:R' '1u ..:.:.:.:::::::::::::::::::.:.:.:.:.:..:.:.:.:.:.:.:.:.....:.::.:.:.:.:.:.::.:.:.:.:.:.:.:.:.:.:.:::::::::::::::::::::::::::::::::::::::: FOR OFFICE USE;ONLY Special Conditions of Permit: ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTO Utilities: General Services: Traffic: 0 Fire: Other: Engineering Technician: pecialist: Publi V-17 ID a Permit No. A tAnwsrobwrsn.marenwad meslas%PaAsheeLAS \—/ kG 8 Public Works Department 949-644-3311 Permit Processing Fee: Inspection Fee: Public Works Only $241.00= Public Works Field Inspection $165.00 Other Department $275.00 Utilities Field Inspection $121.00 General Services Inspection $165.00 Agreement Fee: Water Quality/Artficial Turf Inspection $108.00 Preparation of Report/Agreement $817.00 Document Recordation Fee $192.001 Refundable Deposit: TBDe Monitoring Wells $502.001 Improvements TBD StreeVAlley/Walk Closure: $65.000 Newspaper Rack Inspection $108.00 0 Traffic Control Plan Check 8-1/2" x 11" $65.00 Sewer Connection Fee $250.00 24" x 36" $143.00 4TT Box 3 Cover $64.00 Additional I THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE Revenue Division I REVENUE DIVISION PRIOR TO PAYMENT OF FEES lApproval: 1 I may . 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[Water Meter: Installation Charge $528.00 13/4" Meter $50.25 11" Meter $121.50 Water Meter Boxes: 11 1/2" Meter $285.00 1" DFW Meter Box $96.66 1 11 1/2" Turbine Meter $700.00 2" DFW Meter Box $203.24 B 12" Meter $425.00 12" Turbine Meter $845.00 13" Meter $3,310.00 1 !4" Meter $4,730.00 16' Meter $7,190.00 Certificate of Compliance Fee (+100% of hry over 3 hrs) $288.00 5200-5029 Development Services Fee (Plan check hourly) $155.00 5200-5015 Final Tract Map Checking Fee $2,488.00 5200-5026 Final Parcel Map Checking Fee - Moderate $2,488.00 5200-5027 Lot Line Adjustment Fee $1,079.00 5200-5028 Park Dedication Fee Zone TBD 405470 Street Easement/Vacation Fee (+100% of My over 4 hrs) $1,022.00 5200-5031 Street Tree Fee ($700 Planting Fee) TBD 030-2284 ----- Engineering Tech: TotamOunt Due: For Finance Use Only 7 3(p 00 Permit pe 'alist Receipt No. f�/userslpbw/shared/encroach/masters/ep front and back masters/ Rev. 12/18/2017 epfeesheetxls-revised 11/8/17 4- - 6 8 is Co I ALL UNDERGROUND WORK SHALL BE PERFORMED BY A LICENSED CONTRACTOR I Contact "Underground Service Alert" At Least 48-Hours in Advance of Any Excavation at 800-422-4133 5. 6. 8. 10. 11. 12 13 14 TERMS AND CONDITIONS OF ENCROACHMENT PERMIT Encroachment Permits may be taken out by the owner of benefited property or a licensed contractor A licensed contractor must provide a Letter of Authorization" to allow another party to pull a permit. An approved copy of the permit and construction plan shall be kept at the job site at all times. Work, which has been done prior to issuance of a permit. is subject to rejection/fine. City reserves the right to void permit if work does not commence within 30 days after date of issuance. The Permittee agrees to defend, indemnify and hold the City, its authorized agent, officers, representatives and employees harmless from any responsibility, liability, suit or action of any description arising out of any accident, loss or damage to persons or property occurring as a result of work undertaken under this permit. All work shal! be done in accordance with the approved plans, Standard Special Provisions and Standard Drawings of the City of Newport Beach, and in compliance with all applicable State laws and City ordinances. Permittee guarantees all work performed under this permit to be free of hidden and latent defects. Any failures shall be corrected within two weeks after notification to the satisfaction of the Public Works Director. A valid State licensed contractor must perform all construction within the public right-of-way, unless waived by the Public Works Director. A valid State Contractor License Class A can perform any work in the public right-of-way. For construction or connection to water lines a valid State Contractor License Class C-34 is required. For construction or connection to sewer lines a valid State Contractor License Class C-42 is required. All trenching and/or resurfacing shall conform to City Standard 105-L for pa(kway/roadway and City Standard 140-L, in the alley, where a minimum half -alley width resurfacing shall be provided, unless otherwise directed by the Public Works Dept. Contractors shall obtain permits to perform excavation or trench work from the California Division of Industrial Safety prior to commencing underground construction as required by State law. Walls and faces of all excavations over 5 feel in depth shall be protected by a shoring system, sloping of the ground, or other equivalent means. Trenches less than 5 feet in depth shall be guarded when hazardous ground movement may be expected. The Public Works Department Inspectors must inspect all work in the Public right-of-way. Forms and subgrade must be inspected and approved before concrete is ordered/poured. Sewer, pipelines, and subgrade construction must be inspected and approved before backfilling, or applicant may be required to excavate site. Separate Utilities Department or General Services Department inspections may be required depending on scope of work performed. All trench restoration must be inspected by the Public Works Department. No utility installation(s) shall be allowed over or within 5 feel of any City utilities, unless approved by the Public Works Department. Locate and pothole existing City -owned utilities 6e water, sewer, or street lighting conduits) to verify locations. Maintain a one -foot clearance over or under existing City -owned utilities. Sewer cleanouts require VCP or PVC SDR35 be used with a 4TT box over the riser. Properly lighted barricades must be provided and maintained around all trenches, excavations and obstructions. All signs, flags, lights and other warning and safety devices shall conform to the requirements of the current "Manual of Warning Signs. Sights and Other Devices for the Use in Performance of Work Upon Highways", issued by the California Department of Transportation. If needed, barricades can be obtained from the City at a charge of $10.00 per barricade per day, with a minimum charge of $35 00. It is the responsibility of the applicant to place barricades to protect the general public. Access to fire hydrants must be maintained at all limes. Work within or near beach sensitive areas will not be allowed during, City holidays, spring break, Memorial Day weekend, summer between June 15 and September 15, and during the holiday season from December 19 to January 1 unless approved by the Public Works Department. Any work that extends into traffic or parking lanes and impedes the normal flow of traffic requires the applicant to acquire a Temporary Street Closure Permit from the Public Works Department. Access for fire, police and emergency vehicles must be maintained at all times Traffic Control must be per Work Area Traffic Control Handbook (WATCH). No nighttime traffic lane closures, unless prior approval has been granted. Any lane(s) closure on a major street will only be allowed between 9:00 a.m. and 3:00 p.m. (Monday thru Friday), unless approved by the Public Works Department. Any work affecting the Stale Highway's traffic or within the State Highway right-of-way will require a Caltrans Permit. All vehicles shall be lawfully parked This permit does not authorize the closure of sidewalks, streets, or alleys for construction access, storage of materials, or parking of construction vehicles unless detailed on an attached Temporary Street Closure Applicant must notify USA at 1-800.227-2600 2 days before starting any underground construction. Applicant must notify all affected residents 24 hours in advance of restricted access and any inconveniences. Refuse or unused materials shall be. removed within 24 hours after completion of the work. If not removed, the City may remove and bill the applicant. Coordinate alley closures with City's refuse pick-up days by calling 949-644-3066 for the collection schedule so service is not interrupted. To place a dumpster or materials in the public right-of-way, a Temporary Street Closure Permit must be obtained from the Public Works Department. WORKER'S COMPENSATION INSURANCE (Section 3800 Labor Code) I certify that 1 have a Certificate of consent to self-ins;ter ' icate of Worker's Compen ation Insurance, or a Certified Copy t reo Date: / Signature CERTIFICATE OF EXEMPTION (Section 3800 Labor Code) I certify that in the performance of the work under this permit, I shall not employ any person so as to become subject to California Worker's Compensation Laws. If, after signing this certificate I become subject to the Worker's Compensation provisions of the State Labor Code, I must comply with the provisions of Section 3700 or this permit shall be deemed revoked. Date: Signature: CONTRACTOR LICENSE EXEMPTION As the Owner of the benefiting property, I certify I am personally performing all work in the Public Right -of -Way. Date: Signature: HOLD HARMLESS STATEMENT I understand that I am locating minor encroachments within the City Right-of- Way/Easement. As property owner it is my responsibility to maintain the encroachments. I will be responsible for replacing the improvements if the City removes them for maintenance of utilities or other public need. I shall indemnify and hold the City harmless for any liability associated with the minor encroachments. Date: Signature: 24-hour notice for Encroachmen Per nspe tion is required by calling Public Works at 949-644-3310. 15. Any above ground utility facilities will require documented approval from the adjacent affected property owner(s). 16. Homeowner, contractors, and subcontracotrs may each be liable for violations of Water Quality Laws. Best Management Practices will be enforced. It is against the law to discharge construction debris into the gutter and storm drain. Felony violations of Water Quality Laws are punishable by fines up to $25,000 and/or up to three years in Stale prison plus the full cost to clean up an illegal discharge or spill. 17. If a refundable deposit was paid, applicant must submit a Soils Compaction Certificate or Evidence of a Slurried Backfill and request a final inspection from the Public Works Department. Monies may be held for six months after final inspection before a refund will be processed. 18. No trees in the public right-of-way shall be planted, removed, trimmed, or relocated without approval from the General Services Department. 19. All work in the public right-of-way must meet the approval of the Public Works Department or corrections will be required (i.e. removals, exposing connections, etc.). Additional inspection fees may be required. 20. Permit is for standard materials in the public right-of-way only, unless previously approved by Public Works and an Encroachment Agreement has been processed. 21. Permit is valid for "description" of work noted on front only. Additional work performed may require issuance of a separate permit and/or additional fees. No work related to this encroachment permit $hall be performed until the Public Works Department has Issued this permit. Applicant hereby eknowledges he/she ha7—a-z and erstan s the terms and conditions of this permit and he/she agrees to abide by them. Permit is void If work is not commenced within 30 days after Issuance. Permit fees are nonrefundable. Date: Y�^ignature: 3 ---------- Al" C Pu1cE (ac K1 g 95 36 u. xE>w� _ pY.Ggr. I N RA6 oWpP* 04 i ,`,�_.- .__ - ---- R'.8 X E N'rp•16'22i i—�-�'•'-' �` • • _ �... / i. �. � , di IO i LOCARON Or EA75nNO SCWEa LATEaµ TO BE '&�LWUL J E R 1 h , / 5`'." :.-:.a--i ..< _ .__ �Ol '@ c I�; • N'f VEasIEC 9" CON:RACTOR x rIELO PRIOF TO {� .WEE31 ) 75250TW CONSTRUCTION 6 F j)3�T �•� . IRCC � 11 9_ _ yz P. N b0 rJ N Y%. C&C or, ypEWA�. - .. _.• v 22J 65Rr R A 5 S - 5 ARWWAY pRAIN �, N 222 eARV-N fib. __ - A/. �. �• r 222.S iNV { - \'Jf. m WAC Nu1�� { �.' �. ti GARAGE - 2 24, v (B SPA W .4, • a \ 225 WAD-71 1� OR! VFNAY •% L i r r \ `•"+ \ h N -_ (.f' •'�— , r / '' 3. ; iP j CONTRACTOR TC RECOSTRUC' EO$I'NC / °- _ 15 . 'L4 '� v - OS e7:_,,,- • ! ,i .. 2239{Wv Qw' -1 sRI cPr.Ac:s n� RI1 .V bar 7i ' O O OT BLIC y. 6 / 'a a.- • S _ WORKS NSPECIORICa,RN(C Br .. cm I E `Rt . Ts``2 PGRCf ■ (JB'.,8•) 2 _ ,7Y...• •.•�; A,<- - - i CS N PROPCSEO {e• 803 ME L'- P V. _ re= — � �E LOCATION (SEE LANDSCAPE ^ � 9 f:-' -- -- o PLANS)�N. `' `/a w 111} I� 226.9•�Cr: l;,V N / �S.os 7 ti •' , ` '4 .�• 226 33PAO 9 fa ' <BW 27640 i 22 Pw PORCH — — .. . r KI o I aAADPr v L I LOT ZZ SYNTHETIC- TURF(` &I B v'�p TRACT.N0.6623 2rbs�"-0 Y 2 S.� 7 E- o I �' M.M. 247/16-20 27,7yNY x N e PRCnOSEO {e• eo3 ,TINE o n , O� I - Imo(10 _ ouaoN (SEE :AND$(AP♦ y Wr ]9.16 I .ni I y 1 •' GE 2 ■ `r1 Of as VANS) - e 9 773. S 10 Os — - e a �/6 GARAGE "� � � _ �- 270 SOCIT ✓ i!'�.ROC".�• - IG /1 7NE V6 c22563PD JV- 22" > .. L pRIVEWAr F_-'•.,J �' E57S -. / _. .-. �[ ... .. .. 111-10' Y J ,�- ) (Ic lfibdu •). j , 9 ST 10.69 JON It,CA'O NO SIDEWALK • ... . . A �' . 6 „ l 4 G R R S 5 9 : s,� �'�' °s ' �`!", .• 1 ° •S.�' IC 7� 7�IC 71 �r U ,o O5 7',��? 6 "°d° ' S Sr T0.66.9{ y� 10Y �y At 222. 36104V _Li:m l alr=1.1T.�_ - ��t�::aJQa� is .: �'rt:=:S� _7_=a.�'L- -- �f .mLtT7rt N76i9'56•E _ - _ _ 105 e7' - ET05T BLOCK wql (PROTCC, a1 RACE) 2D' 222.SWNV-OUr /. - 222.0WNV-IN c O co"TTTWCi G. WM IiMOAu 6 6� 1 fQl C: K('rT A1O QTRL, CONSTRUCTION NOTES O CONSTRUCT EARN RV 1 . NEAT PEW PLM (STRWGTIWAL GALS e 1 f � SRG DETAILS Br OMERS) ON e1004 L06 WALL ,y `D T.lro l6 OROOM EXSTWG PAVCWENT. CJM a GUTRR. 410 CONSTRUCT Q ,0', Ksm.n4 WW., APPROAp1 r1PE •. RR Orr 510. 162-1 C GaSN41C, auR Rl[T RCR IXEAA 90ET '. 1A EANSNRK' AW[R ClEAM011T PER Orr 5,0. VAR {OFl /N P()R �� t O2 PLUG ENST OIWERAV APPROA01 PER OTV SIG PLAY 16f_L. WALL O9 =STRWcr O3vEWA Afors,eAM "%fps PER mcmi Cr'S PLAI• O aEWOA EWSTNG TIDE Earel3EC/ CITY OF NEMIPORT 9fAVM lOR OWARC COVER N LOU OF NNVNTE 9DEWMR EERWD OWB -�!r�., � / %•'a 6 CONSM3C1 0%WLOA 0— SXRWTM PER MTAR SKEET I SCALE I•.5• J 3 C05,aNCf 6' r1Eo1 COKTRR ORI,EWAY O OaSIW1Cr A' OW. 501 A0 (�R 3f) DRAW POE a Pl• O O C GRADING PLAN O O ApAl51 (AI$TWO WARP WErta ro aAIX ATO R[RAR 'z O CINSIRWCT RTRI DEPd AC' (1' WOE. �� DEEP; ua COA, ALL AM! �ISIaDG, 1' OA Sa N7 (SOP YS) PEREORARD PAW .00 ^-EgyA,,,- -- -F.. yr.a Pea rO P•rCN B.a W[TEa ea ON roNK a•rt W. RR OTr srt. LIAR f62-L- 2067 PORI 9R,STOL CIR. NEWPORI 9EA04. CA 92651 P0P•^� O WAS ERWRE• .PA.w• 1EV{9101eB .�rPAIm u.wA WPOIRErRA o: --- 4'0OP* s CONSTWCI PARRW MOIRi PER CIM 510 PAR 196-L GEQTMMCAL 80L1 TKM. aC. CALC*AMIZ GROUP P INO. -- .rP.WRe D �(� wrt0� ,6 © WSTµ; AViLMANY, TROODI PEP DEiAII gel, 27. rNICKY. SU1E 210 165x0 BARE PARKWAY, SIPTE 105 ~- CA. 926Te 1 OtSOEO 1,Ill� RVIRE. CA 97615 TEL (714) 397-5911 m/31/16 sO j� jjp�jj�'� C Oi WSTALL eOTTOTRESS TRE4CH DRAW PCR IXrAE SM! I. MI: 949-{53-0{06 DRAWN NG }`-f �'P'Es"�r W �srw SNCR 2 p 4 PW0.ECT 00. 0-4BOB-06 ylPlpp[W IXWw. P(. xCA >•569 — s/14/2018 City of Newport Beach 6:34:18AM INSP150 - Daily Inspection Request Report Requested Inspection Date: 05/14/2018 Inspection Type: ENCROACH Inspection Area: PW Site Address : 2067 PORT BRISTOL CIR AIPM Information: Page 10 of 12 Activity : N2018-0258 SubType : NEW Status : APPROVED OWNER: TALON PARTNERS Phone : 949-345-1001 APPLICANT: CHASE GENERAL ENGINEERING CONTRACTOR Phone : 714-914-6345 Description : CONSTRUCT 2 NEW DRIVEWAY APPROACHES PER STD 162-L, PLUG EXISTING APPROACH PER STD 165-L, 2 NEW CURB DRAINS PER STD 184-L, REPAIR SIDEWALK, CURB AND GUTTER PER STD'S. Requested Inspection(s) Item: 10200 PRE JOB - PW Requested Time: 5/14/2018 12:00:OOAM Requestor: WEBUSER 714 914-6346 Entered By: WEBUSER Comments: AM - Assigned to: zzzzzzzzzzz` )- C' ty 67 cti'6' � (03/4 // c 5/29/2018 City of Newport Beach Page 10 of 11 6:34:07AM INSP150 - Daily Inspection Request Report Requested Inspection Date: 05/29/2018 Inspection Type: ENCROACH Inspection Area : PW Site Address : 2067 PORT BRISTOL CIR A/P/D Information: Activity : N2018-0258 SubType : NEW Status : APPROVED OWNER: TALON PARTNERS Phone : 949-345-1001 APPLICANT: CHASE GENERAL ENGINEERING CONTRACTOR Phone : 714-914-6345 Description : CONSTRUCT 2 NEW DRIVEWAY APPROACHES PER STD 162-L, PLUG EXISTING APPROACH PER STD 165-L, 2 NEW CURB DRAINS PER STD 184-L, REPAIR SIDEWALK, CURB AND GUTTER PER STD'S. Requested Inspection(s) Item: 10110 CONCRETE PUBLIC WORKS Requested Time: 5/29/2018 12:00:OOAM Requestor: WEBUSER 714 914-6346 Entered By: WEBUSER Comments: ANY- Assigned to: 77777777777`. LSI�v S/C. 5/29/2018 City of Newport Beach Page 7 of 16 4:30:09PM INSP150 - Daily Inspection Request Report Requested Inspection Date: 05/30/2018 Inspection Type: ENCROACH Inspection Area: PW Site Address : 2067 PORT BRISTOL CIR Activity : N2018-0258 SubType : NEW Status : APPROVED OWNER: TALON PARTNERS Phone : 949-345-1001 APPLICANT: CHASE GENERAL ENGINEERING CONTRACTOR Phone : 714-914-6345 Description : CONSTRUCT 2 NEW DRIVEWAY APPROACHES PER STD 162-L, PLUG EXISTING APPROACH PER STD 165-L, 2 NEW CURB DRAINS PER STD 184-L, REPAIR SIDEWALK. CURB AND GUTTER PER STD'S. Item: 10210 PUBLIC WORKS Requested Time: 5/30/2018 12:00:OOAM Requestor: Entered By: WEBUSER Comments: ANY - Assigned to: 77777777777* Inspector: 't3S Date: S- 3o- i 8 WEBUSER 714 914-6946 Time: '1., 00 & PM Comments: rwcmo Qo-R -re, pouba-/ 0'u C6- I-18) F:\Users\PBW\Shared\ENCROACHVAASTERS\FORMS\InspectorSheet.doc REPT131 Run Id: 4018 5/30/2018 4:30:09PM City of Newport Beach Page 10 of 18 INSP150 - Daily Inspection Request Report Requested Inspection Date: 05/31/2018 Inspection Type: ENCROACH Inspection Area: PW Site Address : 2067 PORT BRISTOL CIR Activity : N2018-0258 SubType : NEW Status : APPROVED OWNER: TALON PARTNERS Phone : 949-345-1001 APPLICANT: CHASE GENERAL ENGINEERING CONTRACTOR Phone ' 714-914-6345 Description : CONSTRUCT 2 NEW DRIVEWAY APPROACHES PER STD 162-L, PLUG EXISTING APPROACH PER STD 165-L, 2 NEW CURB DRAINS PER STD 184-L, REPAIR SIDEWALK. CURB AND GUTTER PER STD'S. Item: 10100 FORMS WITH COMPACTION - PW Requested Time: 5/31/2018 12:00:OOAM Requestor: WEBUSER 714-330-7178 Entered By: WEBUSER Comments: PM - Assigned to: 77777777777' Inspector: Date: Time: A PM Comments: iftWC IL -o✓' uj C r ;Z4o tj rio& i I V j�l �cC.�c fo ke Yk vkloVed Y, F:\Users\PB\N\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc AL MPT131 Run Id: 4018 N 2��8 02Sg Z067 Par+ Br;u4ol COW Inspector:'AAC, Date: Comments: F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMSYnspectorSheet.do Time: AM PM REPT131 Run Id: 4018 eL .4.