Information

  • Prepared By:

  • Date:

Inspection Results:

  • Activity Detail:

  • Walsh Crew / Sub Contractor
  • Company:

  • Superintendent:

  • Foremen:

  • Buildable Unit (Bridges):

  • Buildable Unit (Retaining Walls):

  • Area Work Was Performed:

  • Results of inspection(include findings, deficiencies observed, and corrective action taken):

  • Photographic Documentation:

Test Results:

  • Test(s) Performed:

  • Test(s) Performed:

  • Test(s)#
  • Ticket #:

  • Slump ( " ):

  • Air ( % ):

  • Concrete Temperature ( ° ):

  • Ambient Temperature ( ° ):

  • Vibration Monitor(s) Used:

  • Monitor Placement:
  • Monitor Number:

  • Type of Structure & Limit:

  • Location:

  • Type of Work Performed:

  • Photograph of Placement:

Certification:

Certification

  • The above report is complete and correct and all material, equipment, work performed, and tests conducted are in strict compliance with the terms of the contract except as noted herein.

  • Walsh Representative Signature

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