594 COASTAL OAK LN - DENSITY 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)9 279-0085 F:(912)279-0086
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ecslimited.com Sof Co9ST4C O4x LANE
Work Order#:
REPORT OF IN PLACE DENSITY RESIDENTIAL Project#: • - -
Subdivision: _ Reported to: Report#:
Unit or Parcel: Location By: Gauge#:
Date Tested:
Lot#Block: Contractor:
Street Address: City:
Method: Course: •
Material: Specific Requirements:
Pass/ Elev/ Base/LR/ Dry Max.Dry % of Max Moist
Fail/ Location Depth Asphalt/ Density Density* Density
Retest /Lift Thickness
__;• _
*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-10(rev.01/18) white copy-office use yellow copy-personal use pink and goldenrod-client use
Page of
FORM BOARD ELEVATION CERTIFICATE
Duval County / Clay County
Left copy on site No box
Lot and Subdivision:
DATE: g - la / .9
PERMIT
NUMBER: ReS 1g - 0 179
ADDRESS: 5'9 Coa Sia f OrA ){ 111.
REQUIRED SLAB ELEVATION ON CITY
APPROVED SITE PLAN: j i , SIO
ACTUAL ELEVATION OF FORM BOARD OR
GRADE STAKE: I I , 9 B
SURVEY COMPANY
NAME: Bartram Trail Surveying, Inc.
1501 CR 315, Suite 106
Green Cove Springs, FL 32043
SIGNATURE OF SURVEYOR: (Party Chief)