Testing and Inspection Forms

Updated structural test and special inspection report forms are provided below for convenience and voluntary use by DSA accepted testing facilities. These forms depict the mandatory information/statements and the desired format. Mandatory information includes: addressee (typically the school district), DSA file and Application Number, specified requirements, cc list (architect, structural engineer, project inspector, and DSA) and the two conformance statements. Note that reports need not match these forms exactly. Additional information may be provided, test data may be rearranged, or other minor changes may be made. However, use of these standardized, electronically fillable forms is strongly encouraged since standardized forms will expedite review of reports by DSA and other parties to the project.

Test Report Forms

(These forms are to be completed, printed and signed for submittal to DSA and CCs indicated.)

• DSA 201: Soil Compaction (PDF - 154 KB) | (DOC - 277 KB) Revised 02/16/11
• DSA 202: Sieve Analysis (PDF - 162 KB) | (DOC - 237 KB) Revised 02/16/11
• DSA 203: Tension/Bend (PDF - 132 KB) | (DOC - 235 KB) Revised 02/16/11
• DSA 204: Compression (PDF - 202 KB) | (DOC - 241 KB) Revised 05/17/11
• DSA 205: Concrete Masonry Unit (PDF - 175 KB) | (DOC - 260 KB) Revised 06/28/11
• DSA 206: Anchor Load (PDF - 152 KB) | (DOC - 251 KB)Revised 02/16/11
• DSA 207: Masonry Core Shear/Compression (PDF - 127 KB) | (DOC - 236 KB) Revised 02/16/11
• DSA 208: High Strength Bolt (PDF - 121 KB) | (DOC - 246 KB) Revised 02/16/11
• DSA 209: Fireproofing Density (PDF - 126 KB) | (DOC - 230 KB) Revised 02/16/11
• DSA 210: Ultrasonic (NDT) (PDF - 140 KB) | (DOC - 280 KB) Revised 02/16/11
• DSA 211: Additional Comments (PDF - 60 KB) | (DOC - 217 KB) Revised 09/22/11  | Non-fillable Version (PDF - 53 KB)

Special Inspection Report Forms

• DSA 250: Special Inspection (PDF - 152 KB) | (DOC - 225 KB)Revised 02/16/11  | Non-fillable Version (PDF - 58 KB)

Verified Report Forms

Note that Verified reports must be submitted on these forms.

See the DSA Forms page for current versions of these forms:

• DSA 291: Laboratory Verified Report || Instructions
• DSA 292: Special Inspection Verified Report || Instructions Revised 09/22/11
• DSA 293: Geotechnical Verified Report || Instructions Revised 01/24/12