576 Coastal Oak Ln density report F:77 Ellis&Associates inc. Corporate
7084 Davis Creek Road,Jacksonville,FL 32256 P:(904 880-0980 F: 904 880-0970
!EGroup of Companies Branch Location:
Gaote imiral•Construdan Materiels•EnNmnmenbl•Facilws Bmnsvnck: 134 Newman Drive,Brunswick,GA 31520 P:(912)279-0085 F:(912)279-0088
Daytona: 2706 S.Rid9evmod Ave.,Suite 2 P:(386)944-9588 F:(386)944-9589
ellisassoc.com South Daytona,FL 32119
Work Order#: X14
REPORT OF IN PLACE DENSITY RESIDENTIAL Project#:
Subdivision: r)1k ?.t-✓<N C t Reported to: Report#:
Unit or Parcel: — Location By: << Gauge#:
Lo[#BDate Tested:
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Street Address: l �'�' C '�� L ` .. k S City:
Method: t Course:
Material: Specific Requirements:
Puss/- M1 Elev/ .Base(LR/ Dry Max.Dry % of Max Moist.
Fait/ Location epth -Asphalt/ Density Density* Density %
Retest /Lift Thickness
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*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
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