1733 ATLANTIC BEACH DR - DENSITY REPORT Corporate
Bari 7064 Davis Creek Road,Jacksonville,FL 32256 P:(904)880-0960 F:(904)880-0970
Ellis&Associates i1C. Branch Location:
Geotechnical • Materials Testing • Environmental • CEI Services Brunswick: 227 Rose Drive,Brunswick,GA 31520 P:(912)279-0085 F:(912)279-0086
Integrated Engineering Services
ellisassoc.com
Work Order#: i
REPORT OF IN PLACE DENSITY RESIDENTIAL Project#:
Subdivision: - Reported to: Report#:
Location By:
Gauge#:
Unit or Parcel:
Date Tested:
Lot#/Block: 30 Contractor:
Street Address: 17 z City:
Method: ,� Course: `
Material: f Specific Requirements: _.P
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Fail/ Location Depth Asphalt/ Density Density* Density %
Retest /Lift Thickness
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*Source oroctor (Project#and/or Work Order#)
---P st Meets Specification Requirements F- Test Fails To Meet Specification Requirements R- Retest
To Be Completed In Field L'~�.
Standby Approval P::-) ,
Employee Name
Time Superintendent Printed Name
Start/Stop Travel Standby Job
Superintendent Signature
(Office use) f
EA-10(rev. 11/14) white copy-office use yellow copy-personal use pink and goldenrod-client use Page of /
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