Report , Main Office Salem Office Bend Office
P.O. Box 23814 ,.i60 Hudson Ave., NE P.O. Box 7918
Tigard, Oregon 97281 Salem, OR 97301 Bend, OR 97708
Carlson Testing Inc • Phone (503) 684 -3460 Phone (503) 589-1252 Phone (541) 330 -9155
FAX (503) 684 -0954 FAX (503) 589 1309 FAX (541) 330 -9163
November 21, 2005
T0509536.CTI
Permit No. MST2005 -00210
FIELD INSPECTION REPORT
DATES COVERED: November 2, 2005
PROJECT: Willey Residence — 3 Car Gara a Addition
ADDRESS: 8855 SW Scheckla — ,
INSPECTOR: E.T. Williams — COP #663, ICBO #0850262 -88, OBOA #374
11- 02 -05: CTI representative was on site as requested to observe installation of epoxy
anchored all- thread studs into existing concrete for seismic tie -downs B8 & STD7. Simp
- Strong Tie "E722" adhesive used in properly drilled and cleaned holes per approved plans.
Batch # 085154GG, expiration date of July 2007 and ICBO # ER 4945.
*** CHECK ONE BOX ONLY*** YES NO
1. This is a preliminary inspection only. — OR — ❑
2. The work inspected conforms to acceptance criteria listed above. If "No," the portions of the
work that are non - conforming items are clearly stated above and will be added to the NCL.
Remaining portions of the work, which are not preliminary in nature, are to be considered as ® ❑
conforming.
Our reports pertain to the material tested /inspected only. Information contained herein is not to
be reproduced, except in full, without prior authorization from this office.
If there are any further questions regarding this matter, please do not hesitate to contact this
office.
Respectfully submitted, .
CARLSO TESTING, INC.
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Neil S. Shannon
Project Manager
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cc: Gary Willey
City of Tigard Building Dept
CSA Consulting Engineers