Report (5) MCC.208-0o94-7
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Bend Office (541) 330-9155
i Geotechnical Office (503) 601-8250
Eugene Office (541) 345-0289
Carlson Testing, Inc. SalemEugene Office (503) 589-1252
Tigard Office (503) 684-3460
Daily Report of Proprietary Anchors
Client: APEX LABORATORIES LLC - DARWIN THOMAS
Project: APEX LABS - ARGON TANK PLACEMENT CTI Job#: T1805873.
Address: 6700 SW SANDBURG STREET TIGARD OR Jurisdiction: TIGARD
CTI representative R. MONTGOMERY OBOA 1119/WABO SI 02145,WABO 3592
was on site this date Jan. 03, 2 019 to perform Special Inspection for:
Permit MEC2018-00947
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.
PER NOTE SK1 PAGE 1 OF INSTALLATION
DARWIN
Name: INSTRUCTIONS. 1/2" X 8" HILTI HAS E ANCHORS.
Company: APEX LABS
ANCHORS INSTALLED VERTICALLY WITH 3-3/4"
2. Inspection was "IBC" I I Continuous X Periodic EMBEDMENT, (1) AT EACH CORNER OF BASE ARGON TANK
AT SOUTH EAST CORNER OF WAREHOUSE. (4) OF (4)
PROPRIETARY ANCHORS INSTALLED WHILE ON SITE.
YesNoN/A
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: X Completed n In progress
4.Verified installation of the anchors. x 2. Completed work inspected was in compliance with
5. Verified anchor diameter. x 71 Approved plans and specifications n Shop drawings
6. Verified steel grade. x
7. Verified hole diameter. x
n RFI � Design change � Submittal � N/A
8. Verified type of drill bit used. x Document #(s) APPROVED PLANS Dated: 4-23-18
9. Verified hole cleaning method. X 3. Noncompliance item(s) were noted this date, details on
10. Verified adhesive application. x following page(s). n Yes n No 7 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 n No x N/A
13. Verified installation torque. x
II Conform n Remain in progress
Evaluation report number & date:
ESR 3814 Report(s) findings were discussed and left with
DARWIN
1/2017
of APEX LABS
Name of product being installed HILTI HIT-RE 500 V3
Batch Number 140105L3
Expiration Date 10/2019
Based on the 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.
71 See additional report page(s). Distribute attachments. Page 1 of 2
Daily Report of Proprietary Anchors For: 01/03/2019
CTI Job #: T1805873.
Project: APEX LABS - ARGON TANK PLACEMENT
Notes:
In some cases more than one box may be checked for a given item on the front page.
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.
Doug Loftesness Reviewed By: Project Manager
Project Manager Review Date:01/07/2019
RM/HH
CC: APEX LABORATORIES LLC - DARWIN THOMAS DTHOMAS@APEX-LABS.COM
ABHT STRUCTURAL ENGINEERS - CLINTON AMBROSE CLINTON@ABHT-STRUCTURAL.COM
AIR PRODUCTS & CHEMICALS - ADAM ANDREWS ANDREWAC@AIRPRODUCTS.COM
8430 SW HUNZIKER ST,TIGARD OR-PO BOX 230997,TIGARD OR 97281
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