Dispatch Request Form
SUBMIT ONE REQUEST PER INSPECTION REQUEST TYPE
Permit Number (Enter IS permit number to Auto Populate Fields)
Project Number (Enter project number to Auto Populate Fields)
Project Name
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Project Address
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Jurisdiction
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Permit Number
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Project No.
Job Check in and Out Information
IOR Contact Name
IOR Contact Phone
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IOR Contact Email
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GC Contact Name 1
GC Contact Phone 1
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GC Contact Email 1
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Start Date of Inspection
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Month
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Day
Year
Start Date
Start Time Minutes
AM
PM
AM/PM Option
INSPECTION AND OR TEST (Make Selection and then provide detailed information below.)
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OTHER SERVICE NOT LISTED ABOVE:
Describe Other Need
Anticipated Duration of Inspection (if only one day)
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1 Hour
2 Hours
3 Hours
4 Hours
5 Hours
6 Hours
7 Hours
8 Hours
9 Hours
10 Hours
11 Hours
12 Hours
16 Hours
As Needed
END DATE (If scheduling for multiple days)
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Month
-
Day
Year
If scheduling for multiple days, and time spans over weekend, select weekend days that should be included in this request.
Your Inspection Request No.
TIO Line Item Reference (If Applicable)
Upload Inspection Request Package
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URL to Inspection Request Share file
Enter URL for Inspection Request Documents Share File
Project Plans and Previous Inspection and Test Reports
Inspector: Click this link to access all previously completed reports and lab tests for this project.
Onsite Contact for This Request (If different than person making this request)
Onsite Contact Phone Number
Best Place to Park for this Inspection
Additional Information About Request
Upload Project Plans
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URL to Plans Share file
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Provide Detailed Information Regarding Your Inspection or Test Request
All Questions and Attachments must be provided or request will be rejected.
Concrete
Concrete Additional Information
Batch Plant Inspection Required
Please Select
Yes
No
Batch Plant Address
Name of Batch Plant
Street Address
City
State / Province
Postal / Zip Code
Select Other Required Tests
Air Entrainment Check
Flexural Beams
Shrinkage Beams
Self Consolidating Concrete
Floor Flattness - Levelnes
Breaks Required - Select All That Apply (Standard Set is 4 Samples 1@7, 2@28, 1@H)
1 Day
2 Day
3 Day
4 Day
5 Day
6 Day
7 Day
8 Day
9 Day
10 Day
11 Day
12 Day
13 Day
14 Day
15 Day
16 Day
17 Day
18 Day
19 Day
20 Day
21 Day
22 Day
23 Day
24 Day
25 Day
26 Day
27 Day
28 Day 2-6x12 or 3-4x8
Hold
Other
Approved Mix Design
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Comments Regarding this Concrete Placement
High Strength Grouting
Breaks Required - Select All That Apply (Standard Set is 3@28, 2"x2" cubes) If you want early breaks, additional sets need to be taken.)
1 Day
2 Day
3 Day
4 Day
5 Day
6 Day
7 Day
8 Day
9 Day
10 Day
11 Day
12 Day
13 Day
14 Day
15 Day
16 Day
17 Day
18 Day
19 Day
20 Day
21 Day
22 Day
23 Day
24 Day
25 Day
26 Day
27 Day
28 Day (3 @ 28)
Hold
Other
Comments Regarding this HS Grout Placement
Reinforcing Steel
Address of Rebar Fab Shop or Supplier
Name of Shop or Supplier
Street Address
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Contact at Rebar Fab Shop
First Name
Last Name
Contact at Rebar Shop Phone Number
Please enter a valid phone number.
Fabrication Related Drawings
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Mechanical Anchors (Installation and Torque)
Anchors (Installation and Torque) Additional Information
Epoxy Anchors
Epoxy Anchors Additional Information
Structural and Misc. Steel
Approved WPS and Welder Certs
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Offsite Fabrication Shop Address
Offsite Fabrication Shop Address
Name of Shop
Street Address
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Contact at Steel Fab Shop
First Name
Last Name
Phone Number at Steel Fab Shop
Please enter contact phone number
High Strength Bolting
High Strength Bolt Supplier Address
Name of Supplier
Street Address
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Fire Resistive Systems
Upload Approved UL Information
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Pull Testing (Tension) - Anchors
Pull Testing (Tension) Additional Information
Upload Photo(s) of Installed Anchors to Show Access
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Approved Detail Showing Load and Anchors.
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Pull Testing - Ceiling and Seismic Wires
Pull Testing - Ceiling and Seismic Wires Additional Information
Upload Approved Details for Testing Requirements
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Soil and Asphalt Testing
Upload Geotechnical Report
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REQUESTED BY
Enter your information here. Add additional email address to receive updates regarding this request.
Name
*
First Name
Last Name
Role on Project
*
Phone Number
*
Email
*
Updates of this request will be sent to this email.
If request is submitted by Independent Solutions - Indicate how the request originated. (Call, Text or Email - If email - indicate date and time of email with subject line.)
Click Here to Add Additional Contacts to Receive Updates About This Request
Additional Contact 1
example@example.com
Additional Contact 2
example@example.com
Additional Contact 3
example@example.com
Additional Contact 4
example@example.com
Additional Contact 5
example@example.com
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ASSIGNED INSPECTOR(S) INFORMATION
This section will be completed by Independent Solutions Dispatch Team. Do not change any information below.
Status
Please Select
Inspector Assigned - Schedule Confirmed
Unassigned - WIP
Rejected
Cancelled By Jobsite Rep
Modification to Team Selection
Account On Credit Hold
Assigned Inspector (Enter Name to Auto Populate Fields Below)
Assigned Inspector
Assigned Inspector - Required Inspection Forms to Be Completed
Assigned Inspector Phone Number
Please enter a valid phone number.
Assigned Inspector Email Address
example@example.com
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Concrete Sampling & Batch Plant Team
Assigned Sampling Technician (Enter Name to Auto Populate Fields Below)
Assigned Sampling Technician
Use for Pull Testing Helper Also
Assigned Sampling Technician - Required Forms to Be Completed
Please Select
Concrete Sampling with Data Sheets for Each Set of Samples
Assigned Sampling Technician Phone Number
Please enter a valid phone number.
Assigned Sampling Technician Email Address
example@example.com
Assigned Sampling Technician #2 (Enter Name to Auto Populate Fields Below)
Assigned Sampling Technician #2
Assigned Sampling Technician #2 - Required Forms to Be Completed
Please Select
Concrete Sampling with Data Sheets for Each Set of Samples
Assigned Sampling Technician Phone Number (#2)
Please enter a valid phone number.
Assigned Sampling Technician Email Address (#2)
example@example.com
Assigned Sampling Technician #3 (Enter Name to Auto Populate Fields Below)
Assigned Sampling Technician #3
Assigned Sampling Technician #3 - Required Forms to Be Completed
Please Select
Concrete Sampling with Data Sheets for Each Set of Samples
Assigned Sampling Technician Phone Number (#3)
Please enter a valid phone number.
Assigned Sampling Technician Email Address (#3)
example@example.com
Assigned Batch Plant Inspector (Enter Name to Auto Populate Fields Below)
Assigned Batch Plant Inspector
Assigned Batch Plant Inspector Phone Number
Please enter a valid phone number.
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