SIDF_0742557-10_1.rev_1Page 1 of 1 Report No: SIDF:0742557-10/1 Special Inspection Daily Field Report Issue No: 1 Professional Service Industries, Inc. 10025 South Tacoma Way, #H1 Tacoma, WA 98499 Phone: (253)
589-1804 Fax: (253) 589-2136 Project: No: AMERICAS CREDIT UNION YELM WA Client: AMERICAS CREDIT UNION PO BOX 33338 FT. LEWIS, WA 98433 These test results apply only to the specific locations
and materials noted and may not represent any other locations or elevations. This report may not be reproduced, except in full, without written permission by Professional Service Industries,
Inc. Approved Signatory: Donald Miller (Special Project Manager) Date of Issue: 9/15/2011 CC: DOUG PALMER, GARY CARLSON, JOHN BARTHELD, KATHY DEGMAN, MARY TEXIDOR, RICK ADAMS Date: 9/9/2011
General Contractor: Permits: Weather: Clear Type of Inspection Performed Reinforced Concrete Structural Masonry High Strength Bolting Fireproofing New Inspection Re-Inspection Reinforcing
Steel Soils Welding Other Standby Time: Field Observations & Comments Specia?????l Inspection Continuous Periodic Location(s)/Item(s): Reinforcing steel and concrete placement @SOG
A-K/1-10 Referenced Details/Drawings: Structural drawings by 2 PA pages S1.1-S2.1-S2.2 12/30/10 Remarks: As requested a representative from PSI was on site for inspections & testing
during concrete placement. Observed the placement of concrete, Holroyd mix 5551F25 3000 Psi @28 days. Concrete placed with a boom pump and consolidated by rodding and screed. Concrete
sampled at the truck, test performed for temperature 68, slump 5 ¼” & air 1.3%. 5 Cylinders (4” X 8”) cast for compressive strength test. Prior to the placement of concrete, this above
referenced location was inspected for reinforcing steel and noted to comply with the structural drawings. No exceptions noted. To the best of PSI’s knowledge, the work inspected to the
approved construction documents are: Conforming Non-Conforming Inspector: Tony Carson Inspector Cert No.: ICC 5104640 Jobsite Representative: