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Report (50)
Bend Office (541)330-9155 Geotechnical Office (503)601-8250 Carlson Testing, InC. eo°ec�eSal (541)345-0289 Tigard Office (503)589-1252 gar (503)684-3460 Daily Report of Proprietary Anchors Project: ?a/ .,o„ A/id 4e°1...+Pr 7-0,0..0-A f.P Afc-0.,•/ 47-/'13 Address: I'7 3 ?2 ct✓ r esirts7 //oi%4, Sa. Tie,,.-d CTI Job#. CTI representatives f"-)k f2.. H ,--.'''-4—'7--.7 -+9��'/ O,Z ,7 to perform �" 1 9� was on site this date �'�4� prispector Name&Cert.No.) Special Inspection for GiWermit [DFS#(s) ,1S7070/7 — O©40/2, jurisdiction `lima r I In some cases more than one box may be checked for a given item. SCOPE OF INSPECTION Location of proprietary anchors inspected[to include grid lines,elevations(floors)and drawing details]: I.Checked in with superintendent or client representative. (----/ ` 4,o1 c a„ S,'.7,,,,,,s,,,7-- i,,,,,,,„./ 7.-001 4,,,,,,,,,,f. Name: 7.'hi company: �Q>ly�.a,r f`�Ir...co 1 ads�0.r✓ c,-,..5 . ki,•> .„0.-..c> f,7170//()s"s.+g 71,s rw.o4J ex,w(reks r.,,,./ ./..."1".•7/40 itt JY 'Y ; "'' ' r's .. 7-x r3-rifle x urn V,2.Inspection was"IBC" ElContinuousID/Periodic " - -4 yI , . u y 10/,�a„tis. Qin-t etero- ea eA S. /e Esot k . £7t1,ae.s...-..r7./>GL Per4-tv.,,,P-Ir;14 Alm:,.7/ /.5--, '��PROPRIETARY ANCHORS rreeers ,tQ.f,,,—,c 07 G*rt S,',..e, Yes No /A A,(lt t,, /.,m sv. //e ea,✓Y r Ile oil; /.f,74 rr1 r ,-✓`,,e 1.Reviewed previous inspection reports? r Iv rfizn,,,,,10 Y J6 sa 2.Reviewed evaluation repori'1 REPORT SUMMARY Verified following items meet manufacturer's published installation instructions. 1.Work inspected was: 3/Completed 0 In Progress 3.Verified minimum embedment depth of the . anchors. V 2.Completed work inspected lavas Q was not 4.Verified installation of the anchors. l/ in compliance with 5.Verified anchor diameter. 1/ 0 Approved plans and specifications. 0 Shop drawings 6.Verified steel grade. 1/ 0 RFI El Design change [4ubmittal Q N/A 7.Verified hole diameter. ,/ Document#(s) f°R Dated: /S`=/ ' 8.Verified type of drill bit used. V 3.Noncompliance item(s)were noted this date,details on 9.Verified hole cleaning method. `€/ following 10.Verified adhesive application. pis) Yes [ o N/A IT:Verified edge distance. 1. 4.Noncompliance item(s)were reinspected this date,details 12.Verified spacing. on following page(s). 0 Yes El No ErN/A 13.Verified installation torque. j f 0 Conform ❑ Remain in progress Evaluation report number&date: Report(s)findings were discussed and left with `.S k ..2-4-4g g oy c/7 1 / i /Jd/1 •�- M�1 1/4.2e/1 of t/r »o" Name of product being installed ,...<17-XP Batch Number b V).4-062 G ' Expiration Date P p3/i 7 Based onthe Code;approval is required from the Building Official before the SPECIAL INSPECTED items noted above can be covered.Carlson Testing has no authority to direct work of contractors or subcontractors. Inspector Signature: _(, • f /r• .; Cyr ' 0 See additional report page(s). 0 Distribute attachments. Page i of 4____ PropAnchors Ver.1 2/12/2009