Edison High School CTE Shade Structure Project

103-22
Test Mark
LIST OF STRUCTURAL TESTS AND SPECIAL INSPECTIONS
Project has a geotechnical report or construction documents require special inspection by a geotechnical engineer.
Project does NOT have and does NOT require a geotechnical report.
TYPE BY TYPE BY
S1 | SOILS - GENERAL C1 | CAST-IN-PLACE CONCRETE
S1a: Site Preparation See Notes PI C1a: Mix Design Continuous SI
S2 | COMPACTION AND FILL C1b: Reinforcing Steel Test LOR
S2a: Fill Materials Test LOR* C1c: Concrete Material Test LOR
S2b: Fill Placement Continuous LOR* C1d: Strength Test Test LOR
S2c: Compaction Test LOR* C1e: Batch Plant Inspection Periodic SI
S3 | DRIVEN DEEP FOUNDATIONS (PILES) C2 | PRESTRESSED CONCRETE
S3a: Materials and Members Continuous GE* C2a: Tendons and Anchorage Test LOR
S3b: Pile Capacity Test LOR* C2b: Tendon Placement Periodic SI
S3c: Driving Operations Continuous GE* C2c: Concrete Strength Periodic SI
S3d: Pile Installation Continuous GE* C2d: Stressing Operations Continuous SI
S3e: Specialty Piles * * C3 | PRECAST CONCRETE
S4 | CAST-IN-PLACE DEEP FOUNDATIONS (PIERS) C3a: General Fabrication Continuous SI
S4a: Drilling Operations Continuous PI C3b: General Erection Periodic SI*
S4b: Pier Construction Continuous PI C3c: Diaphragm Connections Continuous SI
S4c: Bearing Strata Continuous GE* C3d: Diaphragm Tolerances Periodic SI
S5 | RETAINING WALLS C4 | SHOTCRETE
S5a: Backfill Placement Continuous GE* C4a: Placement Continuous SI
S5b: Soil Reinf. and Drainage Continuous GE* C4b: Shotcrete Material Test LOR
S5c: Segmental Retaining Walls Continuous GE* C5 | POST-INSTALLED ANCHORS
S6 | OTHER SOILS C5a: Inspection See notes SI*
S6a: Soil Improvement Test Test GE* C5b: Test Test LOR
S6b: Soil Improvement Inspection Continuous GE* C6 | OTHER CONCRETE
S6c: Not used. N/A N/A C6a: Not used. N/A N/A
S6d: Not used. N/A N/A C6b: Not used. N/A N/A
S6e: Not used. N/A N/A C6c: Not used. N/A N/A
S6f: Not used. N/A N/A C6d: Not used. N/A N/A
S6g: Not used. N/A N/A C6e: Not used. N/A N/A
S6h: Not used. N/A N/A C6f: Not used. N/A N/A
S6i: Not used. N/A N/A C6g: Not used. N/A N/A
S6j: Not used. N/A N/A C6h: Not used. N/A N/A
S6k: Not used. N/A N/A C6i: Not used. N/A N/A
S6l: Not used. N/A N/A C6k: Not used. N/A N/A
S6m: Not used. N/A N/A C6l: Not used.
S6n: Not used. N/A N/A Not used.
* See Appendix for additional information. * See Appendix for additional information.
Project Name: Edison High School Application No.: 02-123614 Increment:
School District: Stockton Unified File No.: 39-H7
DGS DSA 130 (3R-e2v2i s(eRde v1i2s/e0d1 7/2/32)4 /25) Page 1 of 4 2 of 10
DIVISION OF THE STATE ARCHITECT DEPARTMENT OF GENERAL SERVICES STATE OF CALIFORNIA

DSA 103 - 22
LIST OF STRUCTURAL TESTS AND SPECIAL INSPECTIONS
TYPE BY TYPE BY
M1 | STRUCTURAL MASONRY S/A1 | STEEL AND ALUMINUM
f'm PSI:
M1a: Mill Certificates - Reinf. Periodic SI* S/A1a: Material Identification Periodic *
M1b: Material Certificates Test LOR S/A1b: Unidentified Material Test LOR
M1c: Strength Test Test LOR S/A1c: Steel Fabrication Periodic SI
M1d: Mortar Proportions Periodic SI S/A1d: Buckling Restrained Brace Test* LOR
M1e: Grout Proportions Periodic SI S/A2 | HIGH-STRENGTH BOLTS
M1f: Batch Plant Inspection SI S/A2a: Product Verification Periodic SI
M1g: Core Tests Test LOR S/A2b: Bolts, Nuts, and Washers Test LOR
M1h: Prisms Continuous SI S/A2c: Snug Tight Periodic SI
M1i: Dowels and Supports Periodic SI S/A2d: Pretensioned / Slip-Critical * SI
M1j: Reinforcement and Members Periodic SI S/A3 | WELDING
M1k: Reinforcement Placement Continuous SI S/A3a: Weld Material Periodic SI
M1l: Grout Placement Continsuous SI S/A3b: Certificate of Compliance Periodic SI
M1m: Unit Layup and Joints Periodic SI* S/A3c: WPS and Qualifications Periodic SI
M1n: Cold/Hot Weather Work Periodic SI S/A4 | SHOP WELDING
M1o: Anchors and Embeds Continuous SI S/A4a: Weld Category A Continuous SI
M1p: Grout Cavity Continuous SI S/A4b: Weld Category B Periodic SI
M2 | VENEER OR GLASS BLOCK PARTITIONS S/A4c: Stairs and Railing Periodic SI
M2a: Mortar and Grout Periodic SI S/A4d: Reinf. Steel Weldability Periodic SI
M2b: Unit Layup and Joints Periodic SI S/A4e: Reinforcing Steel Continuous SI
M2c: Wires and Connector Periodic SI S/A5 | FIELD WELDING
M2d: Anchors and Embeds Periodic SI S/A5a: Weld Category A Continuous SI
M2e: Cold/Hot Weather Work Periodic SI* S/A5b: Weld Category B Periodic SI
M2f: Adhered Veneer Bond Test LOR S/A5c: End Welded Studs Periodic SI
M3 | POST-INSTALLED ANCHORS S/A5d: Deck Welds Periodic SI
M3a: Inspection Varies* SI* S/A5e: Cold-Formed Steel Periodic SI
M3b: Test Test LOR S/A5f: Stairs and Railing Periodic SI
M4 | OTHER MASONRY S/A5g: Reinf. Steel Weldability Periodic SI
M4a: Not used. N/A N/A S/A5h: Reinforcing Steel Continuous SI
M4b: Not used. N/A N/A S/A6 | NONDESTRUCTIVE TESTING
M4c: Not used. N/A N/A S/A6a: Ultrasonic Test LOR
M4d: Not used. N/A N/A S/A6b: Magnetic Particle Test LOR
M4e: Not used. N/A N/A S/A6c:Not used. N/A N/A
M4f: Not used. N/A N/A S/A6d:Not used. N/A N/A
M4g: Not used. N/A N/A S/A6e:Not used. N/A N/A
M4h: Not used. N/A N/A S/A7 | STEEL JOISTS AND TRUSSES
M4i: Not used. N/A N/A S/A7a: Fabrication Continuous SI
M4j: Not used. N/A N/A S/A8 | SPRAYED FIRE-RESISTANT MATERIALS
M4k: Not used. S/A8a: Surface and Installation Periodic SI
M4l: Not used. S/A8b: Density Test LOR
M4m: Not used. S/A8c: Bond: Adhesion/Cohesion Test LOR
* See Appendix for additional information. * See Appendix for additional information.
Project Name: Edison High School Application No.: 02-123614 Increment:
School District: Stockton Unified File No.: 39-H7
DGS DSA 130 (3R-e2v2i s(eRde v1i2s/e0d1 7/2/32)4 /25) Page 2 of 4 2 of 10
DIVISION OF THE STATE ARCHITECT DEPARTMENT OF GENERAL SERVICES STATE OF CALIFORNIA

DSA 103 - 22
LIST OF STRUCTURAL TESTS AND SPECIAL INSPECTIONS
TYPE BY TYPE BY
S/A9 | ANCHOR BOLTS AND ANCHOR RODS X | OTHER
S/A9a: Anchor Rods and Bolts Test LOR X01: Product Load Test* Test LOR
S/A9b: Other Threaded Rods Test LOR X02: Non-HSB Installation Torque Continuous SI*
S/A10 | STORAGE RACK SYSTEMS X03: Not used. N/A N/A
S/A10a: Material Verification Periodic SI X04: Not used. N/A N/A
S/A10b: Fabrication Periodic SI X05: Not used. N/A N/A
S/A10c: Anchorage Periodic SI X06: Not used. N/A N/A
S/A10d: Completed System Periodic SI* X07: Not used. N/A N/A
S/A11 | OTHER STEEL AND ALUMINUM X08: Not used. N/A N/A
S/A11a: Not used. N/A N/A X09: Not used. N/A N/A
S/A11b: Not used. N/A N/A X10: Not used. N/A N/A
S/A11c: Not used. N/A N/A EXEMPTIONS
S/A11d: Not used. N/A N/A Those items identified on the DSA-approved construction
documents with a note indicating they are not part of the
S/A11e: Not used. N/A N/A
DSA approval or those items checked below are exempt
S/A11f: Not used. N/A N/A
from test and special inspection requirements. The project
S/A11g: Not used. N/A N/A inspector shall verify all construction complies with the
S/A11h: Not used. N/A N/A approved construction documents.
S/A11i: Not used. N/A N/A
S/A11j: Not used. N/A N/A Soils: Eligible shallow foundation elements**.
W1 | PREFABRICATED WOOD TRUSSES Soils: Eligible deep foundation elements - type 1**.
W1a: Open Web Truss Fabrication Continuous SI Soils: Eligible deep foundation elements - type 2**.
Concrete/Masonry: Eligible post-installed anchors**.
W1b: Metal Plate Truss Fabrication Continuous SI
Concrete: Batch plant inspection for items listed in and
W2 | MANUFACTURED WOOD ELEMENTS
W2a: GL Timber Fabrication Continuous SI complying with CBC Section 1705A.3.3.2.
Concrete: Epoxy shear dowels in nonstructural
W2b: CLT Fabrication Continuous SI
slab-on-grade per CBC Section 1910A.5.4, Exception #4.
W2c: Mass Timber Erection Periodic SI Concrete/Masonry: Reinforcing bar testing for items
W2d: Connections Type A Periodic SI listed in and complying with CBC Section 1910A.2.
W2e: Connections Type B Continuous SI Masonry: Freestanding site walls and retaining walls
W2f: Sealants Periodic SI per DSA IR 21-1.
W3 | OTHER WOOD Concrete: Eligible precast elements**.
W3a: Not used. N/A N/A Welding: Eligible fences and gates**.
Welding: Eligible railing and ramps**.
W3b: Not used. N/A N/A
Welding: Eligible interior cold-formed steel framing**.
W3c: Not used. N/A N/A Welding: Eligible equipment curbs**.
W3d: Not used. N/A N/A Welding: Eligible components supporting MEP
distribution systems**.
W3e: Not used. N/A N/A
Welding: Eligible mounts and recreational equipment**.
W3f: Not used. N/A N/A Welding: Eligible nonstructural components**.
W3g: Not used. N/A N/A
W3h: Not used. N/A N/A
* See Appendix for additional information. ** See Appendix for eligibility requirements.
Project Name: Edison High School Application No.: 02-123614 Increment:
School District: Stockton Unified File No.: 39-H7
DGS DSA 130 (3R-e2v2i s(eRde v1i2s/e0d1 7/2/32)4 /25) Page 3 of 4 2 of 10
DIVISION OF THE STATE ARCHITECT DEPARTMENT OF GENERAL SERVICES STATE OF CALIFORNIA

DSA 103 - 22
LIST OF STRUCTURAL TESTS AND SPECIAL INSPECTIONS
IMPORTANT: This form is only a summary list of structural tests and some of the special inspections required for
the project. Any items indicated on the approved construction documents with a note stating that the items are not part of
the DSA approval are not considered in this form. Generally, the structural tests and special inspections noted on this
form are those that will be performed by the Geotechnical Engineer of Record, Laboratory of Record, or Special
Inspector. The actual complete test and inspection program must be performed as detailed on the DSA approved
documents. The exemption appendix at the end of this form identifies work NOT subject to DSA requirements for
special inspection or structural testing. The project inspector is responsible for providing inspection of all facets of
construction, including but not limited to, special inspections not listed on this form such as structural wood
framing, high-load wood diaphragms, cold-formed steel framing, anchorage of nonstructural components, etc., per
Title 24, Part 2, Chapter 17A.
Legend to TYPE and BY Columns:
Continuous - Indicates continuous special inspection is required.
Periodic - Indicates periodic special inspection is required.
Test - Indicates a test is required.
GE - Indicates special inspection shall be performed by a registered geotechnical engineer or his/her authorized
representative, usually associated with the Laboratory of Record.
LOR - Indicates test or special inspection shall be performed by a testing laboratory accepted in the DSA Laboratory
Evaluation and Acceptance (LEA) Program (i.e., the Laboratory of Record for the project). See CAC Section 4-335.
PI - Indicates special inspection may be performed by a project inspector when specifically approved by DSA.
SI - Indicates special inspection shall be performed by an appropriately qualified/approved special inspector.
Required Verified Reports:
Verified reports are required on
1. Structural Testing and Inspection: Form DSA 291
2. Concrete Batch Plant Inspection: Form DSA 291 the following DSA forms:
3. Post-installed Anchors: Form DSA 291 or DSA 292 DSA 291: Laboratory of
4. Shop Welding Inspection: Form DSA 291 or DSA 292 Record Verified Report
5. High-Strength Bolting Inspection: Form DSA 291 or DSA 292
DSA 292: Special Inspectors
Employed Directly by the
District Verified Report
DSA 293: Geotechnical Verified
Report
Note: To facilitate DSA electronic
mark-ups and identification stamp
application, DSA recommends
against using secured electronic
or digital signatures.
Name of Design Professional in General Responsible Charge: STAMP
Timothy L. Dearborn
IDENTIFICATION STAMP
DIV. OF THE STATE ARCHITECT
Name of Structural Engineer of Record (when applicable): DDDDSSSSAAAA
APP:02-123614 INC:
REVIEWED FOR
SS 4 DDDDFIIIIVVVVLIIIISSSSSIIIIOOOONNNN OOOO4FFFF TTTTHHHHEEEE SSSSTTTTAAAAATTTTEEEEC AAAARRRRSCCCCHHHHIIII4TTTTEEEECCCCTTTT
DEPARTMENT OF GENERAL SERVICES
Signature of Architect or Structural Engineer: Date: DATE: 03/17/2026
03/06/2026
Project Name: Edison High School Application No.: 02-123614 Increment:
School District: Stockton Unified File No.: 39-H7
DGS DSA 130 (3R-e2v2i s(eRde v1i2s/e0d1 7/2/32)4 /25) Page 4 of 4 2 of 10
DIVISION OF THE STATE ARCHITECT DEPARTMENT OF GENERAL SERVICES STATE OF CALIFORNIA

DSA 103 - 22
Appendix: LIST OF STRUCTURAL TESTS AND SPECIAL INSPECTIONS
NOTE: Undefined sections and table references found in this appendix are from the CBC, or California Building Code
S1. GENERAL:
Test or Special Inspection Code References and Notes
S1a: Site Preparation | Verify that:
* Site has been prepared properly prior to placement of
Refer to specific items identified in the Appendix listing
controlled fill and/or excavations for foundations.
exemptions for limitations. Placement of controlled fill
* Foundation excavations are extended to proper depth
exceeding 12'' depth under foundations is not permitted
and have reached proper material.
without a geotechnical report.
* Materials below footings are adequate to achieve the
design bearing capacity.
S2. SOIL COMPACTION AND FILL:
Test or Special Inspection Code References and Notes
S2a: Fill Materials | Perform classification and testing of fill
* Under the supervision of the geotechnical engineer.
materials.
S2b: Fill Placement | Verify use of proper materials, * Under the supervision of a geotechnical engineer or LOR's
densities and inspect lift thicknesses, placement and engineering manager. Refer to specific items identified in the
compaction during placement of fill. end of this form listing exemptions for limitations.
Refer to specific items identified in the Appendix listing
exemptions for limitations. Placement of controlled fill
S2c: Compaction | Compaction testing.
exceeding 12'' depth under foundations is not permitted
without a geotechnical report.
S3. DRIVEN DEEP FOUNDATIONS (PILES):
Test or Special Inspection Code References and Notes
S3a: Materials and Members | Verify pile materials, * By geotechnical engineer or his or her qualified
sizes and lengths comply with the requirements. representative.
S3b: Pile Capacity | Determine capacities of test
piles and conduct additional load tests as * Under the supervision of the geotechnical engineer.
required.
S3c: Driving Operations | Inspect driving operations
* By geotechnical engineer or his or her qualified
and maintain complete and accurate records for each
representative.
pile.
Project Name: Edison High School Application No.: 02-123614 Increment:
School District: Stockton Unified File No.: 39-H7
DGS DSA 130 (3R-e2v2i s(eRde v1i2s/e0d1 7/2/32)4 /25) 2 of 10
DIVISION OF THE STATE ARCHITECT DEPARTMENT OF GENERAL SERVICES STATE OF CALIFORNIA

DSA 103 - 22
Appendix: LIST OF STRUCTURAL TESTS AND SPECIAL INSPECTIONS
S3d: Pile Installation | Verify locations of piles and
their plumbness, confirm type and size of hammer,
record number of blows per foot of penetration, * By geotechnical engineer or his or her qualified
determine required penetrations to achieve design representative.
capacity, record tip and butt elevations and record
any pile damage.
S3e: Specialty Piles | For specialty piles, perform
additional inspections as determined by the registered * As defined on drawings or specifications.
design professional in responsible charge.
S4. CAST-IN-PLACE DEEP FOUNDATIONS (PIERS):
Test or Special Inspection Code References and Note
S4a: Drilling Operations | Inspect drilling operations Continuous inspection to be provided by project
and maintain complete and accurate records for each inspector. Refer to specific items identified in the
pier. Appendix (end of this form) listing exemptions for
limitations.
S4b: Pier Construction | Verify pier locations, Continuous inspection to be provided by project
diameters, plumbness, bell diameters (if applicable), inspector. Refer to specific items identified in the
lengths and embedment into bedrock (if applicable); Appendix (end of this form) listing exemptions for
record concrete or grout volumes. limitations.
S4c: Bearing Strata | Confirm adequate end strata Provide tests and inspections per CONCRETE section
bearing capacity. below.
S5. RETAINING WALLS:
Test or Special Inspection Code References and Notes
S5a: Backfill Placement | Placement, compaction and 1705A.6.1. * By geotechnical engineer or his or her qualified
inspection of backfill. representative. (See section S2 above).
S5b: Soil Reinf. and Drainage | Placement of soil * By geotechnical engineer or his or her qualified
reinforcement and/or drainage devices. representative.
S5c: Segmental Retaining Walls | Segmental retaining
* By geotechnical engineer or his or her qualified
walls; inspect placement of units, dowels, connectors,
representative. See DSA IR 18-2.
etc.
Project Name: Edison High School Application No.: 02-123614 Increment:
School District: Stockton Unified File No.: 39-H7
DGS DSA 130 (3R-e2v2i s(eRde v1i2s/e0d1 7/2/32)4 /25) 2 of 10
DIVISION OF THE STATE ARCHITECT DEPARTMENT OF GENERAL SERVICES STATE OF CALIFORNIA

DSA 103 - 22
Appendix: LIST OF STRUCTURAL TESTS AND SPECIAL INSPECTIONS
S6 | OTHER SOILS
Test or Special Inspection Code References and Notes
Submit a comprehensive report documenting final soil
improvements constructed, construction observation and the
S6a | Soil Improvements results of the confirmation testing and analysis to CGS (California
Geological Survey) for final acceptance.
* By geotechnical engineer or his or her qualified representative.
S6b | Inspection of Soil Improvements * By geotechnical engineer or his or her qualified representative.
S6c. | Not used. N/A
S6d. | Not used. N/A
S6e. | Not used. N/A
S6f. | Not used. N/A
S6g. | Not used. N/A
S6h. | Not used. N/A
S6i. | Not used. N/A
S6j. | Not used. N/A
S6k. | Not used. N/A
S6l. | Not used. N/A
S6m. | Not used. N/A
S6n. | Not used. N/A
Project Name: Edison High School Application No.: 02-123614 Increment:
School District: Stockton Unified File No.: 39-H7
DGS DSA 130 (3R-e2v2i s(eRde v1i2s/e0d1 7/2/32)4 /25) 2 of 10
DIVISION OF THE STATE ARCHITECT DEPARTMENT OF GENERAL SERVICES STATE OF CALIFORNIA

DSA 103 - 22
Appendix: LIST OF STRUCTURAL TESTS AND SPECIAL INSPECTIONS
C1. CAST-IN-PLACE CONCRETE
Test or Special Inspection Code References and Notes
Table 1705A.3 Item 5, 1903A.5, 1903A.7, 1904A.1, 1904A.2,
C1a: Mix Design | Verify use of required design mix.
1910A.1 ; ACI 318 Ch. 19, 26.4, 26.13.3.2.
Table 1705A.3 Item 1, 1705A.3.9, 1908A.1, 1910A.2; ACI 318
Ch. 20 and Sections 25.2, 25.3, 25.5.1, 26.6.1; DSA IR 17-10
C1b: Reinforcing Steel | Identify, sample, and test
and BU 24-02. (See Appendix (end of this form) for
reinforcing steel.
exemptions.)
C1c: Concrete Material | During concrete
Table 1705A.3 Item 6, 1705A.3.9, 1905A.1.17; ASTM C31,
placement, fabricate specimens for strength
ASTM C172; ACI 318 Sections 26.4, 26.5 & 26.12.
tests, perform slump and air content tests, and
determine the temperature of the concrete.
1905A.1.17; ACI 318 Section 26.12.
C1d: Strength Test | Test concrete (f'c).
Default of "Continuous" per 1705A.3.3. If approved by DSA,
batch plant inspection may be reduced to "Periodic"
C1e: Batch Plant Inspection | Batch plant inspection: subject to requirements in Section 1705A.3.3.1, or not
Continuous required per 1705A.3.3.2. See IR 17-13. (See Appendix (end
of this form) for exemptions.)
C2. PRESTRESSED / POST-TENSIONED CONCRETE (IN
ADDITION TO SECTION C1):
Test or Special Inspection Code References and Notes
1705A.3.4 Table 1705A.3 Item 1, 1910A.3; ACI 318 Ch. 20
C2a: Tendons and Anchorage | Sample and test
and Sections 25.2, 26.6.1.
prestressing tendons and anchorages.
C2b: Tendon Placement | Inspect placement of 1705A.3.4, Table 1705A.3 Items 1 & 9; ACI 318 Ch. 20 and
prestressing tendons. Sections 25.2, 26.6.1-26.6.3.
Table 1705A.3 Item 13; ACI 318 Sections 26.10.2, 26.11.2,
C2c: Concrete Strength | Verify in-situ concrete 26.13.3.3. Special inspector to verify specified concrete
strength prior to stressing of post-tensioning tendons. strength test prior to stressing.
C2d: Stressing Operations | Inspect application of 1705A.3.4, Table 1705A.3 Item 9; ACI 318 Sections 26.10.2,
post-tensioning or prestressing forces and grouting of 26.13.1, 26.13.3.2.
bonded prestressing tendons.
C3. PRECAST CONCRETE (IN ADDITION TO SECTION
C1):
Test or Special Inspection Code References and Notes
C3a: General Fabrication | 1. Inspect fabrication of
1705A.3 Item 1, 7. See Appendix for exemptions. *May be
precast concrete members. *
periodic where fabrication occurs in a PCI-certified plant.
2. Inspect reinforcement of the following precast concrete
For underground structures, NPCA plant certification is
elements or system(s):
acceptable. PCI MNL-116-21; PCI MNL-117-13; NPCA
a. special moment frames.
Quality Control Manual (QCM) 17th Edition. See IR A-15.
b. boundary elements of special structural walls.
c. coupling beams.
Project Name: Edison High School Application No.: 02-123614 Increment:
School District: Stockton Unified File No.: 39-H7
DGS DSA 130 (3R-e2v2i s(eRde v1i2s/e0d1 7/2/32)4 /25) 2 of 10
DIVISION OF THE STATE ARCHITECT DEPARTMENT OF GENERAL SERVICES STATE OF CALIFORNIA

DSA 103 - 22
Appendix: LIST OF STRUCTURAL TESTS AND SPECIAL INSPECTIONS
C3b: General Erection | Inspect erection of precast
Table 1705A.3 Item 10.
concrete members.
C3c: Diaphragm Connections | For precast
concrete diaphragm connections or reinforcement
at joints classified as moderate or high deformability
elements (MDE or HDE) in structures assigned to
Seismic Design Category D, E or F, inspect such
connections and reinforcement in the field for: Table 1705A.3 Item 11.
1. Installation of the embedded parts.
2. Completion of the continuity of
reinforcement across joints.
3. Completion of connections in the field.
C3d: Diaphragm Tolerances | Inspect installation
tolerances of precast concrete diaphragm connections Table 1705A.3 Item 12
for compliance with ACI 550.5.
C4. SHOTCRETE (IN ADDITION TO SECTION C1):
Test or Special Inspection Code References and Notes
1705A.3.9, Table 1705A.3 Item 7, 1908A.1, 1908A.2, 1908A.3.
C4a: Placement | Inspect shotcrete
See ACI 506.2 Section 3.4, and ACI 506R.
placement for proper application techniques.
C4b: Shotcrete Material | Sample and test shotcrete 1908A.2 and 1705A.3.9.
(f'c).
C5. POST-INSTALLED ANCHORS:
Test or Special Inspection Code References and Notes
1617A.1.19, Table 1705A.3 Item 4a (Continuous) & 4b
(Periodic), 1705A.3.8 (See Appendix (end of this form) for
C5a: Inspection | Inspect installation of post-installed
exemptions). ACI 318 Sections 26.7.2, 26.13.1, 26.13.3.2,
anchors
26.13.3.3. * May be performed by the project inspector when
specifically approved by DSA.
C5b: Test | Test post-installed anchors. 1910A.5. (See Appendix (end of this form) for exemptions.)
Project Name: Edison High School Application No.: 02-123614 Increment:
School District: Stockton Unified File No.: 39-H7
DGS DSA 130 (3R-e2v2i s(eRde v1i2s/e0d1 7/2/32)4 /25) 2 of 10
DIVISION OF THE STATE ARCHITECT DEPARTMENT OF GENERAL SERVICES STATE OF CALIFORNIA

DSA 103 - 22
Appendix: LIST OF STRUCTURAL TESTS AND SPECIAL INSPECTIONS
C6. OTHER CONCRETE:
Test or Special Inspection
Code References and Notes
C6a. | Not used. N/A
C6b. | Not used. N/A
C6c. | Not used. N/A
C6d. | Not used. N/A
C6e. | Not used. N/A
C6f. | Not used. N/A
C6g. | Not used. N/A
C6h. | Not used. N/A
C6i. | Not used. N/A
C6j. | Not used. N/A
C6k. | Not used. Not used.
C6l. | Not used. Not used.
Project Name: Edison High School Application No.: 02-123614 Increment:
School District: Stockton Unified File No.: 39-H7
DGS DSA 130 (3R-e2v2i s(eRde v1i2s/e0d1 7/2/32)4 /25) 2 of 10
DIVISION OF THE STATE ARCHITECT DEPARTMENT OF GENERAL SERVICES STATE OF CALIFORNIA