___________________________________________________________________________________________________________

Contractor's Quality Control (QC) Plan Section 1-07.34(6)A

Seattle City Light
Terminal 117 Adjacent Streets Cleanup & Stormwater Infrastructure
Seattle, King County, WA

GMCC Job No. 2015-001

REPORT FORM H - QC Inspector's Daily Report (IDR) Report No.

Page 1/
1. Site Location Terminal 117 Adjacent Streets

2. Contractor Name Gary Merlino Construction Company

3. Indicates Required Field

4. Date: 11-25-15 5. Contract Information

6. Work Shifts 7. Contract Unit#

Day Swing Night 8. Contract Unit Description

X 9. Construction Management Company

10. Contractor Work Performed - Include Scope, Quantity, Location, Drawing #s, Inspections, Tests, and Activity ID# (if
available)

GMCC – No Work Performed

No Subs onsite

REPORT FORM H - Inspector's Daily Report (IDR)(contd.) Report No.

___________________________________________________________________________________________________________
Contractor's Quality Control (QC) Plan Section 1-07.34(6)A
Seattle City Light
Terminal 117 Adjacent Streets Cleanup & Stormwater Infrastructure
Seattle, King County, WA

GMCC Job No. 2015-001

Page 2/
11. Subcontractor Name(s) 12. Work Descriptions

12. Third Party Inspection (if required)

None

13. Material Deliverables/Manifests - Basis Code for Acceptance: a. App'd Mtrl List; b. Insp; c. Mtrl Cert d. Plant Cert

Materials Basis Code Buy America Quantity Received Remarks

a Yes No

Yes No

14. Attachments

File Attachment File Attachment File Attachment File Attachment

15. Non-conforming Work (Refer Non-conformance Report No. from Report Form E)

None

GMCC Representative Name GMCC Representative Signature

Patrick Hafferty Patrick Hafferty