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<br /> OTTO ROSENAU&ASSOCIATES,INC.
<br /> SUBSURFACE INTERFACE RADAR INVESTIGATION REPORT;f 9 g 9.
<br /> Job Number: Permit Number: t
<br /> Project: `t./ `- 0 Client/Contact:
<br /> Address: ZeoZ 4,../.,-,;;Ale/(7:.- ,=1 r k.l( r_ Phone Number:
<br /> Date: i f I U , 2 I1 Technicians: i, i.H .. 1. cc5::)1J
<br /> h F
<br /> Important Notice
<br /> The operator has marked the approximate location of subsurface items detected by the equipment. The equipment may
<br /> NOT detect some subsurface items. The client understands this fact and assumes full and complete responsibility for any
<br /> ' subsurface items,detected or not, by the machine. This service is intended to provide information to the client only. Otto
<br /> Rosenau&Associates,Inc. does not assume any responsibility for how the client interprets or utilizes this information. In
<br /> the case of concrete slabs(slab on grade, structural and/or post-tensioned),walls,columns, Otto Rosenau &Associates,
<br /> Inc.strongly recommends that the client does not core, drill,sawcut,bore, and/or excavate within 3"minimum of any
<br /> marked locations by the operators of this equipment.
<br /> 1. Representative to work with survey operator: aka. -)
<br /> 2. Itemized areas cleared for survey: ')Z. S
<br /> 3. Alternate areas available: 4.
<br /> Area and.Purpose of Survey
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<br /> Authorized Signature Title
<br /> Company Name Date
<br /> 'A
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<br /> Tested by.
<br /> e' ` E r"."1--",-..-----//-------------'°,-- Reviewed b
<br /> , �
<br /> - Start Time: ef Finish Time:
<br /> This report applies only to the items tested or reported and is the exclusive property of Otto Rosenau&Associates,Inc. Reproduction of this r....
<br /> di
<br /> except in full,without written permission from our firm is strictly prohibited. H
<br /> Page 7 of
<br /> 6747 M.L.King Way S.,Seattle,Washington 98118-Phone(206)725-4600 or 1-888-OTTO-4-US-Fax(206)723-2221
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