1600 W Park Terr finished floor elevation certification DU VAL COUNT)"
CFR TYI-CA TION OF FIAIISHED FL OOR EL Z-IIA T/ON
THIS FORM /S TO BE COMPLETED SY THE EU/LD/NG CONTRACTOR,
SURVEYOR OR A PROFESSIONAL ENG/NEER AND MUST SE RETURNED
AFTER SLAB INSPECT/ON AND PRIOR TO ANY FURTHER INSPECT/ON
REQUESTS.
BU/LD/NG PERM/T NO 1-7-6 3 3�g- b1 '
ADDRESS.•
L OT NUMBER. �` .3,
SUED/V/S/ON.• ���� '�''C1�
DES/GN MIN/MUM
FIN/SHED FL OOR EZZ-/A TION.-
AS SU/L T
F/N/SHL-D FL 0 O EL EVA T1 ON.
S/GNA TURE.�- 09R
L/CENSE NUMBER. 4600
DA TZ-.-
y
A,
9556 Historic Kings Road • Suite 201
�e Jacksonville, FL 32257 FIELD DENSITY TEST REPORT
Phone: (904) 886-0766
OF JAX,INC. Email: twheeler@agesofiax.com q
AGES JOB NO.: T 1/7 /�, DATE TESTED : !"z 7`11
JOB NAME: i&OD_ k 7e(. W REPORT
CLIENT : )r e f iNjDATE:
✓tetS _ TECHNICIAN : G1�^
LOCATION: 'F -� REPORT NO. :
Test Moisture lAdt Dry Proctor Proctor Relative Com inn
No. Content Density Density Number Density Achieved Required Pass/Fail Test Location Elevation Test Datum
y6 c % FsOt
J iJ cA" rt jr
141 .
U )D1-! fS, '
L r b94 CA e
PROCTOR INFORMATION SUMMARY: The relative compaction results are a quality control measure of the This report shall NOT be reproduced,
Proctor Max. Dry Optimum adequacy of the fill and/or sub-grade compaction effort. The data shown Except in Full, without written approval of
Type Number Density Moisture Soil Type herein is representative of compaction achieved at the specified test AGES OF JAX, Inc.
(Pc� (%) location and depth. Passing density tests should not be construed to be a
Proct "certification" of suitability of the "subsurface soil conditions" and/or an
+�n evaluation of the ability of the subsurface soils to adequately support the REPORTED BY:
1 planned construction.
to i AGES OF JAX, Inc. agrees to keep confidential any and all matters
(�/ rGC O Ir �� r I Ir I4 t Q S < related to these test results and understands that unauthorized disclosure
Remarks U of these test results to anyone other than our clients, or their designated TIMOTHY R. WHEELER, P.E.
representative,without the client's expressed permission, is in violation of
MOD=Modified Proctor Density (ASTM D 1557) AGES OF JAX, Inc. professional ethics and company policy. Registered Fla NO. 42802