Structural Tests and Inspection Schedule
(See Appendix A for Requirements of Uniform Building Code, Section 1701)

Prior to acceptance of a building permit, the Owner, on the advice of the Architect or Engineer, shall complete, sign, and submit this form to the Building Official.
 

Project Name

Project Address

Owner's Name

Date

Testing/Inspection Agency

Signature & Tile

Hereby certifies that the Testing/Inspection Agency named above has been engaged to perform structural tests and inspection during construction, as checked below, to satisfy all applicable portions of the Building Code.

Prior to issuance of an occupancy permit, the Inspection Agency shall submit a statement that all items of designated work performed were reported. Any items checked but not tested or inspected will be noted and explained.

Whenever any designated items on this list are ready for sampling, testing, or inspection, it shall be the responsibility of the Contractor to give timely notice to the Inspection Agency so that the required services may be performed.
REINFORCING STEEL:
___Tensile & Bend, one set per heat per ___ tons
___Inspection of Placement
___Inspection of Welding
MASONRY:
___Preliminary Acceptance Tests (Masonry Units, Wall Prisms)
___Subsequent Tests (Mortar, Grout, Field Wall Prisms)
___Inspection of Grouting
___Inspection of Placement and Grouting
CONCRETE, SHOTCRETE GROUT & MORTAR:
 Conc.  Shot.  Grout  Mortar  
        Aggregate Tests for Designs
    Suitability of Aggregates
        Mix Designs
        Test Panel
        Batch Plant Inspection
        Cement Grab Sample
        Inspect Placing
        Compression Tests
        Cast Specimens
        Pick-Up Samples
        Shrinkage Bars
        Yield Check
        Air Check
        Dry Unit Weight
PRECAST/POST-TENSIONED CONCRETE:
___Reinforcing Tests
___Inspection of Reinforcing Placement
___Tendon Tests
___Inspection of Tendon Placement
___Inspection of Concrete Placement
___Inspection of Concrete Batching
___Inspection of Panel Attachments
___Inspection of Panel Installation
___Compression Tests
___Inspection of Stressing/Transfer
PILING, CAISSONS, CAPS, TIES:
___Inspection of Reinforcing Placement
___Inspection of Concrete Placement
___Inspection of Concrete Batching
UNDERPINNING:
___Inspection of Steel Fabrication
___Inspection of Reinforcing & Forms
___Inspection of Concrete Placement
___Inspection of Tiebacks
STRUCTURAL STEEL:
___Sample & Test (list specific members below)
___Shop Identification & Welding Inspection
___Shop Ultrasonic Inspection
___Shop Radiography
___Field Welding Inspection
___Field Bolting Inspection
___Field Ultrasonic Inspection
___Field Radiography
___Metal Deck Welding Inspection
ASPHALTIC CONCRETE:
___Mix Designs
___Inspection of Batch Plant
___Core/Test
___Field Inspection
___Suitability Tests
___Specific Gravity
___Asphalt Content
___Sieve Analysis
___K Factors
___Stabilometer Valve
___Swell
INSULATING CONCRETE:
___Sample & Test
___Unit Weights
FIREPROOFING:
___Inspection of Placement
___Density Tests
___Thickness Tests
___Inspect Batching
FILL MATERIAL:
___Acceptance Tests
___Moisture-Density Determination
___Field Density
ROOFING:
___Inspection of Placement
___Sample & Test
STRUCTURAL WOOD:
___Inspection of Fabrication
___Inspection of Truss Joist Fabrication
___Sample & Test Components
___Inspection of Glu Lam Fabrication
___Shear Diaphragms

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