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320 10th St RES19-0057 Form Board Elev + Density Test LEGACY In-Place Density Tests: ENGINEERING, INC subdivision/Lot Number: "'^ (Address if no lot Dumber) Gemxhniwl&Materials Fngineeringand R iag Lift/De th %MaxDensi Location 'd6 The above tests meet the specification requirements–Pass O' Fail ❑ (if 1A sre"°w s°—) Notes: This report has not been reviewed by an engineer, LEGACY the final report can be found at LegacyReports.com Date Tested: /�1P _ - REPORTS-COM FAST&EASY ONLINE ACCESS Tested By:ste SL 6424 Beach Boulevard,Jacksonville,FL 32216- 904-721-1100 FORM BOARD ELEVATION CERTIFICATE Date Permit Number: ' Address: All American Surveyors Work Order # Required Slab Elevation on City Approved Site Plan: 1� s� Actual Elevation of Form Board or Grade Stake: 12 41 Survey Company: ALL AMERICAN SURVEYORS OF FLORIDA INC. 3751 San Jose Place, Suite 15 Jacksonville FL 32257 Work Phone: 904-279-0088 Signature of Surveyor: (PartyChief)