1747 MARITIME OAK DR - DENISITY REPORT •
Jacksonville
7064 Davis Creek Road,Jacksonville,FL 32256 P:(904)880-0960 F:(904)880-0970
Brunswick
134 Newman Drive,Brunswick,GA 31520 P:(912)279-0085 F:(912)279-0086
ecslimited.com
Work Order#: ' >
REPORT OF IN PLACE DENSITY RESIDENTIAL Project#:
Subdivision: it c Reported to: Report#:
Unit or Parcel: Location By: Gauge#:
Date Tested:
Lot#/Block: Contractor:
Street Address: h.. `+ r• , City:
Method: Course: `
Material: Specific Requirements: ,
Pass/ Elev/ Base/LR/ Dry Max.Dry % of Max Moist
Fail/ Location Depth Asphalt/ Density Density* Density 0/0
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
Standby Approval
Employee Name
Time Superintendent Printed Name
Start/Stop Travel Standby Job
Superintendent Signature
(Office use)
ECS-I0(rev.01/18) white copy-office use yellow copy-personal use pink and goldenrod-client use 1 f
Page of
FORM BOARD ELEVATION CERTIFICATE
Duval County / Clay County
Left copy on site No box
Lot and Subdivision: ,3t�cr4 cc
DATE: oz_,y_ , S •
PERMIT
NUMBER: /7-O ('- 9
ADDRESS: /7 q �, z Time j
REQUIRED SLAB ELEVATION ON CITY
APPROVED SITE PLAN: ,, qo
ACTUAL ELEVATION OF FORM BOARD OR
GRADE STAKE: /2 G/5
SURVEY COMPANY
NAME: Bartram Trail Surveying, Inc.
1501 CR 315, Suite 106
Green Cove Springs, FL 32043
SIGNATURE OF SURVEYOR: (Party Chief)