Report (34) Bend Office (541)330-9155
Geotechnical Office (503)601-8250
Carlson Testing, Inc. Eugene Office (541)345-0289
Salem Office (503)589-1252
Tigard Office (503)684-3460
April 20,2016
11606180
Permit No: N/A
P.O.No:
FIELD INSPECTION REPORT
DATES COVERED: April 19,2016
PROJECT: Harris—GB—001—Load Testing
ADDRESS: 11960 SW 122"d Ct Tigard OR
INSPECTOR: K.Wallis—ACI#01295086,OBOA#1101
04/19/16—Proof Load Test
A CTI representative arrived on site as requested by David with Lamont Bros Construction to proof load test (4) hold down
anchors in the front of the garage of the house.The anchors were%Z"all thread,(2)on each side of the garage door.CTI spoke
with David and was given permission to cut out the blocking and dry wall in the (2) areas in order to test. The anchors are
numbers#1 is the southernmost anchor,#4 is the northernmost anchor.
#1 anchor failed at 3180 lbs.
#2 anchor held the specified load of 4837 lb.for 1 minute
#3 anchor held the specified load of 4837 lb.for 1 minute
#4 anchor held the specified load of 4837 lb.for 1 minute
4837 lbs.was specified by the engineer design professional for the job.
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. Under all circumstances,the information contained in this report is provided
subject to all terms and conditions of CTI's General Conditions in effect at the time this report is prepared.No party other than
those to whom CTI has distributed this report shall be entitled to use or rely upon the information contained in this document.
If there are any further questions regarding this matter,please do not hesitate to contact this office.
Respectfully submitted,
CARLSON TESTING,INC.
im Suess
Project Manager
KW/sc
cc: Gabe Harris Gabe.jharris@gmail.com
Lamont Bros LLC—David Patrick david@lamontbros.com
Lamont Bros LLC—Joseph.Patrick Joseph@lamontbros.com
West Coast Engineering(WCE)—Sean Ramstead seanwce@gmai1.com
City of Tigard Building Division—Walter"Chip"Barnett Final LTR only I NCL only
8430 SW Hunziker St..Tigard,OR 97223
PO Box 230997,Tigard,OR 97281
04-19-16 fr 610(kw)
Bend Office (541) 330-9155
Geotechnical Office (503) 601-8250
Carlson TestiEugene Office (541) 345-0289
ng, Inc. Salem Office (503) 589-1252
Tigard Office (503) 684-3460
Daily Report of Proprietary Anchors
Client: LAMONT BROS LLC - DAVID PATRICK
Project: HARRIS-GB-001 - LOAD TESTING CTI Job#• T1606180.
Address: 11960 SW 122ND CT TIGARD OR Jurisdiction: TIGARD
CTI representative J. PILAND OBOA 282
was on site this date Apr. 27, 2 016 to perform Special Inspection for:
Permit MST2015-00235
DFS #(s) PO Number:
SCOPE OF INSPECTION Location of proprietary anchors inspected [to include grid
lines, elevations (floors) and drawing details]:
1. Checked in with superintendent or client representative.
Name: DAVID A CTI REPRESENTATIVE WAS PRESENT FOR (1) EPDXY
Company: LAMONT BROS LLC INSTALLATION.
p y SOUTH ANCHOR WAS JACKED BY A CTI
2. Inspection was "IBC" x Continuous Periodic REPRESENTATIVE TODAY, AND REDRILLED TO A DEPTH
OF 8" INTO FOUNDATION STEM WALL. EPDXY PLACED:
PROPRIETARY ANCHORS (1) 5/8" DIAMETER X 18" LONG X 8" EMBED PER
YesNoN/A DESIGN AND ICC REQUIREMENTS.
1. Reviewed previous inspection reports? x
2. Reviewed evaluation report? x
Verified following items meet manufacturer's
published installation instructions. REPORT SUMMARY
3. Verified minimum embedment depth of the
anchors. X 1. Work inspected was: I X I Completed In progress
4.Verified installation of the anchors. X 2. Completed work inspected was in compliance with
5. Verified anchor diameter. X I x I Approved plans and specifications I I Shop drawings
6. Verified steel grade. X
I I RFI Design change Submittal N/A
7. Verified hole diameter.
x
8. Verified type of drill bit used. X Document #(s) A/S 1.1 Dated: 01/04/16
9. Verified hole cleaning method. X 3. Noncompliance item(s) were noted this date, details on
10. Verified adhesive application. X following page(s). Yes No x N/A
11. Verified edge distance. X
12. Verified spacing. X 4. Noncompliance item(s) were reinspected this date, details
on following page(s). I I Yes No x N/A
13. Verified installation torque.
Conform Remain in progress
Evaluation report number & date:
ESR-2508 (07/2015) Report(s) findings were discussed and left with
LANCE
of OMEGA CONCRETE INC
Name of product being installed SIMPSON XP
Batch Number 245T472T
Expiration Date 12/02/16
Based on the Code, approval is required from the Building Official before the SPECIAL INSPEC TED items noted above can
be covered. Carlson Testing has no authority to direct work of contractors or subcontractors.
See additional report page(s). I I Distribute attachments.
Page 1 of 2