1662 MARITIME OAK - DENSITY REPORT EXI
Corporate
7064 Davis Creek Road,Jacksonville,FL 32256 P:(904)880-0960 F:(904)880-0970
Ellis&AssociateslllC. Branch Location:
Geotechnical • Materials Testing • Environmental • CEI Services Brunswick: 227 Rose Dove,Brunswick,GA 31520 P:(912)279-0085 F:(912)279-0086
integrated Engineering Services
ellisassoc.com
•
Work Order#: V
REPORT OF IN PLACE DENSITY RESIDENTIAL Project#: ,• • "_l ,
Subdivision: f-\ : L C..-'c I• C („ Reported to: Report#:
Unit or Parcel: Location By: et Gauge#:
Lot#Block: 12 C Contractor:�'IN t 'e 41,, •r Date Tested: , ' I \.,
Street Address: / --L-2-- 11/4-14-7 I 1-1,4-'t J,:-■c.
City:
Method: ti —Ne Course:
Material: ' ;,-,...1--, Specific Requirements:
Pass/ Elev/ Base/LR/
Fail/ Location Depth Asphalt/ Dry Max. Dry % of Max Moist
Retest /Lift Thickness Density Density* Density %
/f
( /\ 1t - f----:,? ‘;;.,
*Source of Proctor(Project#and/or Work Order#)
P-Test Meets Specification Requirements F-Test Fails To Meet Specification Requirements R- Retest
To Be Completed In Field
Employee Name
-- - Standby Approval
Time Superintendent Printed Name
Start/Stop Travel Standby Job
Superintendent Signature
(Office use)
EA-10(rev. 11/14) white copy-office use yellow copy-personal use pink and goldenrod-client use
Page_of i
FORM BOARD ELEVATION CERTIFICATE
Duval County / Clay County/Nassau County
Left copy on site No box
Lot/Subdivision: 6c c .c .
DATE:
PERMIT
NUMBER: , s�� „Z
ADDRESS: rc,(3z M, _ a
REQUIRED SLAB ELEVATION ON CITY
APPROVED SITE PLAN : I z
ACTUAL ELEVATION OF FORM BOARD OR
GRADE STAKE:
SURVEY COMPANY NAME:
Bartram Trail Surveying, Inc.
1501 CR 315, Suite 106
Green Cove Springs, FL 32043
SIGNATURE OF SURVEYOR: (Party Chief)
— �Ascric