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G:\Forms & Handouts - 2026\Forms\Special Inspection & Testing Agreement (Rev 3-12-2026).docx Page 1 of 5 Special Inspection and Testing Agreement Project: Plan Check No.: Address: (To applicants of projects requiring Special Inspection or Testing per Chapter 17 of the California Building Code) BEFORE A PERMIT CAN BE ISSUED: The owner or his/her representative, on the advice of the responsible Project Engineer or Architect, shall complete, sign and submit the Special Inspection Agreement and Structural Tests Schedule to the Building Division for review and approval. Original and digital signatures are accepted. The owner and his/her general contractor, where applicable, shall also acknowledge the following conditions applicable to Special Inspection and/or Testing: 1. Contractor is responsible for proper notification to the Inspection or Testing agency for items listed. 2. Only the testing laboratory should take samples and transport them to their laboratory. 3. Copies of all laboratory reports and inspections are to be sent directly to this Division by the Testing agency on a weekly basis. 4. Inspection agency to submit names and qualifications of on-site special inspectors to this Division for approval. This will not be required when the agency provides each special inspector with an identification badge that indicates the following: a. Name of inspector. b. Photo of inspector. c. The specific areas in which the Inspector is qualified to inspect. d. An authorization signature by the registered Engineer who is a full-time employee of the agency. e. The special inspector shall display his/her badge whenever performing the function of an inspector. 5. The special inspector is responsible to the Chief Building Official for immediate notification of any concerns and/or problems encountered. 6. It is the responsibility of the contractor to review the Building Division approved plans for additional inspection or testing requirements that may be noted. A pre-construction conference at the job site is recommended to review special inspection procedures. 7. The special inspector shall use only Building Division Approved Drawings. 8. BEFORE AN OCCUPANCY PERMIT CAN BE ISSUED: The inspection agency shall submit a statement that all items requiring testing and inspection were fulfilled and reported. Those items not tested and/or inspected shall be noted in this statement. A copy of the statement shall be maintained at the job site for the Building Inspector’s review prior to final inspections. 9. Constructor responsible for the construction shall submit a written statement of responsibility to the Chief Building Official and the owner per CBC Section 1705.1 where required. 10. Attach a City approved matrix list for all special inspectors showing inspection areas for which they are qualified by experience and appropriate certifications. (See enclosed) ACKNOWLEDGEMENT: Owner’s Name (print) Signature Date Special Inspection Company Name Rep. Signature Date Project Architect / Engineer (print) Signature Date Contractor’s Name (print) Signature Date Approved by Chief Building Official Signature Date ---PAGE BREAK--- G:\Forms & Handouts - 2026\Forms\Special Inspection & Testing Agreement (Rev 3-12-2026).docx Page 2 of 5 STRUCTURAL TESTS AND INSPECTION SCHEDULE (Per CBC Sections 1704, 1705 or 1708) Hereby certifies that the Testing/Inspection Agency named above has been engaged to perform structural tests and inspection during construction, as checked below, to satisfy all applicable portions of the Building Code. Prior to issuance of any occupancy permit, the Inspection Agency shall submit a statement that all items of designated work performed were reported. Any items checked but not tested or inspected will be noted and explained. Whenever any designated items on the list are ready for sampling, testing, or inspection, it shall be the responsibility of the contractor to give timely notice to the Inspection Agency so that the required services may be performed. REINFORCING STEEL: STRUCTURAL STEEL: Tensile & Bend, one set per heat per tons Sample & Test (list specific members below) Inspection of Placement Shop Identification & Welding Inspection Inspection of Welding Shop Ultrasonic Inspection Dowelling Shop Radiography Field Welding Inspection MASONRY: Field Bolting Inspection Preliminary Acceptance Tests (Masonry Units, Wall Prisms) Field Ultrasonic Inspection Subsequent Tests (Mortar, Grout, Field Wall Prisms) Field Radiography Inspection of Grouting Metal Deck Welding Inspection Inspection of Placement & Grouting ASPHALTIC CONCRETE: CONCRETE, SHOTCRETE, GROUT & MORTAR: Mix Designs Inspection of Batch Plant Core/Test Field Inspection Suitability Tests Specific Gravity Asphalt Content Sieve Analysis K Factors Stabilometer Valve Swell INSULATING CONCRETE: Sample & Test Unit Weights FIREPROOFING: Inspection of Placement PRECAST CONCRETE: Density Tests Reinforcing Tests Thickness Tests Inspection of Reinforcing Placement Inspect Batching Tendon Tests Acceptance Tests Inspection of Tendon Placement Sample & Test Inspection of Concrete Placement Inspection of Concrete Batching STRUCTURAL WOOD: Inspection of Panel Attachments & Inserts Inspection of Fabrication Compression Tests Inspection of Truss Joist Fabrication Inspection of Stressing/Transfer Sample & Test Components Inspection of Glue Lam Fabrication PILING, CAISSONS, CAPS, TIES: Nailing and Bolting Drilled Piers Anchoring and Other Fastening Inspection of Reinforcing Placement Inspection of Concrete Placement FILL MATERIAL: Inspection of Concrete Batching Acceptance Tests Epoxy Holdowns Moisture-Density Determination Field Density UNDERPINNING: Inspection of Steel Fabrication Others: Inspection of Reinforcing & Forms Epoxy Anchors Inspection of Concrete Placement Anchor Bolts Installed in concrete Inspection of Tieback Concrete Shot Grout Mortar Aggregate Tests for Designs Suitability of Aggregates Mix Designs Test Panel Batch Plant Inspection Cement Grab Sample Inspect Placing Compression Tests Cast Specimens Pick-Up Samples Shrinkage Bars Yield Check Air Check Dry Unit Weight ---PAGE BREAK--- G:\Forms & Handouts - 2026\Forms\Special Inspection & Testing Agreement (Rev 3-12-2026).docx Page 3 of 5 ROOFING: Inspection of placement Sample & Test SEISMIC RESISTING ELEMENTS (PERIODIC SPECIAL INSPECTION IF REQUIRED UON) COLD-FORMED STEEL FRAMING: Bolting Screw Attachment Anchorage of Other Fastening STORAGE RACKS AND ACCESS FLOORS: Anchorage of Access Floors Anchorage of Storage Racks 8 Feet or Greater in Height ERECTION AND FASTENING OF ARCHITECTURAL COMPONENTS: Exterior Cladding Interior and Exterior Nonbearing Walls Interior and Exterior Veneer FASTENING OF MECHANICAL AND ELECTRICAL COMPONENTS: Electrical Equipment for Emergency or Standby Power Anchorage of other Electrical Equipment in Seismic Design Category E or F Installing of Piping System Specify if other tests, inspections or special instructions are required for the project. ---PAGE BREAK--- G:\Forms & Handouts - 2026\Forms\Special Inspection & Testing Agreement (Rev 3-12-2026).docx Page 4 of 5 RECOGNIZED SPECIAL INSPECTION & TESTING AGENCIES KEY: RC = Reinforced Concrete PC = Pre-Stressed/Post-Tensioned SM = Structural Masonry SS = Structural Steel Welding/Bolting HSB = High-Strength Bolting NDT = Non-Destructive Testing FP = Spray-Applied Fireproofing SWC = Structural Wood Connection URM = Unreinforced Masonry Push/Torque Tests Only SW = Structural Welding Agency Name HQ Address Phone/Fax RC PC SM SS FP URM HSB SWC SW NDT Exp Date Ace Quality Control 3075 Teagarden St, San Leandro CA 94577 (510) 969-4239 X X X X X X X X X X 1/4/2027 Achievement Engineering Corp 1145 S.Third Street, San Jose, CA 95112 (408) 217-9174 (408) 217-9632 X X X X X X X X X X 12/20/2027 Applied Material Engineering 980 41ST St. Oakland, CA 94608 (510) 420-8190 (510) 420-8186 X X X X X X X X X X 10/13/2028 BAGG Engineers 138 Charcot Ave San Jose, CA 95131 (650) 852-9133 (650) 852-9138 X X X X X 12/5/2028 Berlogar, Stevens, & Associates 5587 Sunol Blvd. Pleasanton, CA 94566 (925) 484-0220 (925) 846-9645 X X X X X 10/9/2028 B.S.K. Associates 1181 Quarry Ln., Suite 300 Pleasanton, CA 94566 (925) 462-4000 (925) 462-6283 X X X X X X X X X 4/28/2028 Certerra RMA Group 3150 Fitzgerald Road Rancho Cordova, CA 95742 (916) 631-7256 X X X X X X X X X 2/3/2029 Consolidated Engineering Labs 2001 Crow Canyon Rd., Ste. 100 San Ramon, CA 94583 (925) 314-7100 (925) 855-7140 X X X X X X X X X X 3/20/2029 Construction Testing Services 2174 Rheem Dr., Suite A Pleasanton, CA 94588 (925) 462-5151 (925) 462-5183 X X X X X X X X X 8/1/2026 CTE Cal Inc 46716 Fremont Blvd Fremont, CA 94538 (510) 573-6352 X X X X X X X X X X 2/20/2028 ENGEO, Inc. 2010 Crow Canyon Rd., Ste. 250 San Ramon, CA 94583- 1545 (925) 838-1600 (925) 838-7425 X X X X X X X X X 7/12/2027 Geissler Engineering 83 E Beach Road Belvedere, Ca 94920 (415) 760-5636 X X X X X 5/7/2028 HP Inspections 690 Sunol Blvd, bldg. H San Jose, CA 95126 (408) 288-8460 (408) 271-0902 X X X X X X 6/28/2026 Intertek-PSI 16170 Vineyard Blvd., Siute 170 Morgan Hill, CA 95037 (408)-669-5500 X X X X X X X 4/15/2028 Inspection Services INC 1798 University Avenue, Berkley, CA 94703 (510)900-2100 fax (510)900- 2101 X X X X X X X X X X 7/16/2028 ---PAGE BREAK--- G:\Forms & Handouts - 2026\Forms\Special Inspection & Testing Agreement (Rev 3-12-2026).docx Page 5 of 5 Krazan and Associates, Inc. 1061 Serpentine Ln. Ste F. Pleasanton, CA 94566 (925) 307-1160 X X X X X X X X X X 7/22/2028 Mid Pacific Engineering 840 Ebararcadaro Drive, suite 20, West sacramento, ca 95605 [PHONE REDACTED] X X X X X X X X X X 11/20/2028 MatriScope Engineering Laboratories INC 601 Bercut Drive Sacramento Ca 95811 (916)330-2201 X X X X X X X X X 7/16/2027 Ninyo & Moore 2149 O’Toole Ave, Suite 30 San Jose, CA 95131 (408) 435-9000 X X X X X X X X X X 3/29/2026 Norcon, LLC 470 3rd St, #105 San Francisco, CA 94107 (415) 692-0519 X X X X X X X 10/13/2026 QUANTUM GEOTECHNI CAL, INC 6288 San Ignacio Avenue, Suite A San Jose Ca. 95119 (408)629-3822 Fax (408)629- 3825 X X X X X X 7/1/2027 RGH Consultants 3501 Industrial Drive, Suite A Santa Rosa, Ca 95403 (707) 544-1072 X X X X 2/10/2028 Stevens, Ferrone & Bailey Engineering 1600 Willow Pass Ct. Concord, CA 94520 (925) 688-1001 (925) 688-1005 X X X X X X X X X X 4/25/2029 Structure Groups 2352 Research Drive, Livermore, Ca 94550 [PHONE REDACTED] X X X X X X X X X X 12/15/2028 Terracon 5075 Commercial Circle Ste E, Concord Ca, 94520 (925)609-7224 X X X X X X X X X X 11/5/2028 Testing Engineers, Inc. 2811 Teagarden St. San Leandro, CA 94577 (510) 835-3142 (510) 834-3777 X X X X X X X X X X 8/26/2028 Twining, Inc 5027 Commercial Circle, Ste G Concord, CA 94520 (949) 849-8186 X X X X X X X X X X 3/18/2028 UES 3410 W Hammer Lane, Suite F, Stockton CA 95219 (209) 234-7722 X X X X X X X X X 3/8/2027 Agencies have not been evaluated for geotechnical special inspection or for nondestructive testing. Agencies may not be qualified to perform all aspects of special inspection. Agencies may have offices in more than one location. Other agencies may be approved by local jurisdictions. *Agency Sub-Contracts Laboratory Services