Inspection Request

LAWA

LOS ANGELES WORLD AIRPORTS

Contractor Tracking #

Project Name:

Project LAX (LAWA) #:

Start Date/Time of IR

End Date/Time of IR

Prime Contractor

Title (Trade Partner - Area - Description of Work)

Location (Level / Area / Segment / Station)

Prime QC

Prime Contact

Subcontractor

Field Contact

Plan Sheet #

RFI #

Submittal #

Room #

ASR/USR/LIR #

Permit #

Specification Division

Type of Inspection:

Initial Inspection Re-Inspection Time & Material

Notification of Start of an Activity Request for Deputy Inspection / Standards Division / Testing Approved Disputed Work

Notification LADBS / AHJ was Requested Off-Site Material / Fabrication (72 hour Notification)

Description of Requested Inspection:

LAWA INSPECTOR COMMENTS:

Inspection Request Status:

LAWA Inspector:

Inspector's Name:

Date:

LAX Terminal 5 (DA-5795.01) Inspection Request - Hensel Phelps R12 format. Used on the T5 project only. Attach approved IREQ, RFIs and door/QC paperwork where applicable.