2075 Cliff Rd - Special Inspection & Testing Schedule Permit#101366
RECEIVED
DEC fi 2011
SPECIA1,1]O PECTf4N AND "i<"ESMG SCMMUL T,
PiolcaName 107.5 =Road 1~xc}yecr io. ] 1416-Qt1
Location Pagan, MR _
QMM S Pauuit No a ® 36 &
SPECIAL IxsFEC1Tt?NSt~HEDTJ)t
Type Of Rtrpcirt AW
tiaa. Fhm n. piim
5tiuc~ussl SICeII'' bt►
-Aig11 S Ba . Tasting welded 41-7,, ,AI C.
iald W A aonnectioes
Notes,
Tlsis. Sclscdufet to bo filloct otu .and irsp~deut ia, ~e:gra,~eat doss: tstfain sznuvnilebta at that tIma to bo
filled ant wiusn tiprlyitt~ i~ a b~tlingperasi#. .
(1) PNa, to bo prrsv~tl by th_e ~uildi~g Of$cial.
(2) Use demlPUiw pcs lJL..C. Soatlas 1704.
(3) SMitstIstspccter,Testing. AStorlAricnior.
(4) F~ c~tstt~ts~ tu:p ca$
Each Wr to rapteswa ivemust sip below-
(?umer .gate:
A12 Z" \.Ftm - Cciyiractor - , r` ~?irad! sl ' L • ~ (I'~ Sato; I
Archi i'gnelt:ina. --pp". f l ,n=
1-7
F~:_lelRydt Assoa. 37sta;
S'Ir Fish, lbsttzs:
i
M. Pate
TA: Firm: M~~ lw~C~ me: ~ 11
F: Finn: I3abo;
F: Fkm; „ Dstw
Legend, SM-Stnwtuml.EnginaerofRecord SI-Special luspeace
TA=Tes*&Agent T Fabrioatvr
or Tl*'.in&vidW uama of& pmspcctivt spedal inspectors 4ndtlw vnric IlWiutersd to observe must 'be
ideaMed *a the ravcrso side ottli. feats.
Acx~pted.fortha Building.Mpartmeat By: Uate:
1
AMERICAN
Pg 1 of ~
ENGINEERING RECEIVED
Ton NG, INC. DEC it 2011
NDT FIELD REPORT
CLIENT: -re.51411lrrrt AETJOBNO:
PROJECT. 20-Y5 C hff Rj DATE: /d -n
RESULTS: c
0 eNs~i,i sx 3 44 a+,Ct 9 n Cow
Z-146 connec Abm-r. a met l✓t4u G000~+uc. 4tS - ]"~t s~zer drab
-4, 1 art i iii I` klrehlP S a~ Gtr~ravwrfT /yp p~7Fi.3!~'.
art eaa4MP oP rte-4 Iced ws D'/. / -0 8
AMEHILAN
E
r
71B
TIME:
MILEAGE:
CLIENT REPRESENTATIVE AET TECHNICIAN cx
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06-NDT 117B (8-03)