EXHIBIT 3 SWT Form 982 - Quality Assurance Report.pdf

QUALITY ASSURANCE REPORT

DIRECTIVE 1130-2-550

PART 1 - NOTIFICATION

. D This report constitutes notification to the contractor of the deficiencies cited below.

D This report confirms oral notification to the contractor on

COR Signature

Type or Print name if not electronically signed

PR NO LOCATION

swr Form 982 23 Oct 2010

PART 2 - QA INSPECTION RESULTS

DESCRIPTION OF DEFICIENCY

ALL PREVIOUS EDITIONS ARE OBSOLETE

of the deficiencies cited below.

Date

PRIMARY SECONDARY

INSPECTION INSPECTION

No. lnspec. No. Def. No. lnspec. No. Def.

PROPONENT: CESWT-OD

QUALITY ASSURANCE REPORT

Cotinued

PART 3 - CO DECISION ON DEFICEINCIES

D The deficiencies in meeting PR No. (s) must be corrected before the work

Will be accepted.

□ will be deducted from scheduled payments to the contractor for the deficiencies

Meet PR No.(s) . Calculations for this deduction are given under part VI.

COR Signature Date

Type or Print name if not electronically signed

PART IV- NOTIFICATION

I certify that all deficiencies have been corrected in accordance with the contract specifications.

Contractor Signature Date

Type or Print name if not electronically signed

PART v -ACCEPTANCE

All work except that for which deductions will be made complies with the contract specifications and is hereby accepted.

Contractor Signature Date

Type or Print name if not electronically signed

SWT Form 982

ALL PREVIOUS EDITIONS ARE OBSOLETE PROPONENT: CESWT-OD

23 Oct 2010