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Report ars _1_11k� c EPDXY INSPECTION REPORT 13(eie,CSEJ /Ad -Jr. l 6i ,20 --002-66 Date: 9/1/2021 File#: K212503c Project Name: Mark Luu Addition, 13665 SW Liden Contractor: Jose Garcia Construction Permit#: N/A Inspector: Eric Phillips,ACI ICC Weather: Sunny Ambient Temperature(°F): 66 Embedment Hole Diameter Type of Diameter of Total Length Quantity Element and Location Depth (in) (in) Insert Insert(in) of Bolt/Dowel E.side foundation,N.end of addition,wall 2 4 5/8 Deformed Dowels 1/2 36 in foundation E.side foundation, S.end of addition,wall 5/8 Deformed Dowels 1/2 36 In 2 foundation 4 E.side foundation, N.end of addition,footing 1 6 5/8 Deformed Dowels 1/2 36 in E.side foundation,S.end of addition,footing 1 6 5/8 Deformed Dowels 1/2 36 in l Manufacturers instructions were followed for installation and preperation Confirmed that holes were cleaned by: Brush Blown out ❑Drill Mounted Vacuum or Dust Extraction Device ® Holes are ready for epoxying and installation of said items. 0 Observed injection of epoxy into holes. Epoxy Brand/Type: Epoxy Expiration Date: Sufficient epoxy coating was acheived. Witness installation of a total of: Bolts Anchors Smooth Bar Dowels Threaded Bar Dowels 6 Deformed Bar Dowels Work Inspected was: © in compliance 0 except as noted 0 reinspection/retesting required Notes: As per plans, sheet S2.1. E-mail results to Jayden Garcia, jrgarci2@gmail.com ®This Report is Preliminary. Inspector: Date: A preliminary report is provided solely as evidence that field observation was performed. Observations and/or conclusions and/or 9/1/2021 recommendations conveyed in the final report may vary from and shall take precedence over those indicated in a preliminary report. Note'.The recording of false,fictitious or fraudulent statements or entries on this document may be punishable as a felony under Federal Statute. DThis Report is Final. A final report is an instrument of professional service. Any conclusions drawn from this report should be discussed with and Reviewed b y Date: evaluated by the professional involved. NOTICE: Our firm's professionals are represented on site solely to observe operations of the contractor identified,to form opinions about the adequacy of those operations,and to report those opinions to our client. The presence and activities of our field representatives do not relieve any contractor from its obligation to meet contractual requirements. No one except our client may rely on our findings and opinions.The contractor retains sole responsibility for site safety and the methods,operations,and sequences of construction. Contractor Initials: www.oneatlas.com Rev.Sept 28,2020