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STRUCTURAL OBSERVATION REPORT FORM
STRUCTURAL OBSERVATION means the mualo madon olfM1e shuelumisystem, bFpamnl con/omwnre to the mAvm,d
plans and Weditatbns, at&gdfi ntmmshuctlon step$ aW&GO (W ortha a( tuWspEm. ShuoN2lobservatlontl s
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❑ Footing. Seem Walls,
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❑Steel Moment Femme
❑ConnmeOR
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❑Mat Fountlation
❑Masonry
O SIetl BraeeE Frame
❑Meal Carl
❑ Galsam. Pile$ Grace
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❑Conoele Momem
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❑ Reaming Foundation
❑Others
❑Masonry Wall Frame
❑Cal
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❑ Oltrea:
NOTED DEFICIENCIES real the proposed comapontlag cortaglve actions vnT respect to genemi conformance
vilde the approved pans or In a toad path: (Afine; report by NO structural obsonren which stales that all observed
delklenciss here bem BaNwd is reoviretl aware att ptan.^e Beer, vm i by Me budding scab.)
T ATTMEFOLLOWING STATEMENTS ARE TRUE TO THE 9ESTOFMvxxMw GF
II AM THE E�lN�R OR ARCHITECT RETAINED BY THE OMM TO HE IN R��NSIB�
CHARGE FOR�ES�UC��LO�ERVA�OMM�CORDAKCEWTHIH�REQUIREMEWS
OF THE CFO( BE I-Cor A�ELM.
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Observation Report
Abnedess lS Avalon Veto Newport Coast CA rt.nyUyniyYr, RW1f00448 Steel 1LOSE
SIC Nnc Avaon Verde II Project Amhave¢ Design Wall Architecture
Seel Donl M ASTM Ad15 Grade 60 RStar
6^9nter. KNq En 'n
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1, Observed Ne rneallafion of(2a)-q5 horizontal dowels Min a min.a" embed into the existing snar le wall
sMmn M the new to existing s"Cuml tie-ins of the taaknl ace well section at the northeast Comer M the
Chiller grey of the proposed new Rae Center Par vial 1 (fmmvly Let 12 A 131.
2, Obsenred the inalelHhon of4-H hunz(a ldowels will a min .8" embedinto the avrgart ahMaete wall
Section for the new to VISSIng stmctuml 4cins of the tap sadden 0the castJrtplaa wall Section at the nohh
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eastcorneroftheChillerAria 9 the pmpased new Rec. Center of Parch I(Mmedy Lot 12&13).
3. Venfied the Size, depth and cleat llnees of boles prior the Polestlar ISimpson SET XP Epokf W
#123C246L exp. 02-26-13.
4. Verifies the placement of einforcin steel at Its following locations she Lower Level call -in -place wall aetlion
on the hall end of the Chiller Artery of the emelmed rare, Rae Center of Pareall fformery Iat 12813.
5. Vented reirre rin Steel br size, grede, lap, lo[etioq and pearahce.
9. Work coaelved, unless noted otnerwrse above, Is m accordance with the approved plans and s ecdca ons.
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Observation Report
A[4EMety 15 AvalOn Vale Newport Curet CA {bMI worse, RW1100446 RW110046
Lao wore Avalon Vista II Project MEikast, Design West Architecture
MamW Doolpuort Concrete Mix Desin%R5500P42 Ggiev KNA Engineering, Inc.
coal hers Portion Getz Ommomwor. NaNu Development
anni 4" a 8. OuemM= 0ywKDdaaty: KP Construction
1fndWwFOGuneh Reinplcatl Concrete Parliament qt 00-2511
oewFNry
1. Otani the Alec lmerit & consolidation of 14 cu. ytla. W concrete, mix design ORS50OP42 (6000 PSI) al the
following locations: the Lower Level lrrmurson concrete bating; sections on the north sche of Me Chiller Array
and on the north side M the Garage Vehicular En", and the Lower Level foundation ca54in-INax retaining wall
maker on War north side of Ga2ce Vehicular Entry 0 the Imposed new Rec. Center aP
Lot 12 613).
2. One slid of 4' x 0"=4 tied Clundras was taken from Lead pt (10 on Pole.), ticket 01761 truck 0979 placed
the Lower Level foundation concrete looting sections on the north side of the Chiller Arlay and on the north side
of the Garage Vehicular Entry of Oe programed new Raw. Canter of Pamal 1 (formerly Let 12 & 13).
3 slump led result 4'.
4. Concrete was supplied by Robertson Readv Mlx.
5. Work observed, unless noted othervAse, i, In accordance with the approved plane and specihokona.
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