Report (2) • RECEIVED
(31-4/0?0/7 - 670().6"y AUG 31 2020
Bend Office (541) 330-9155
9ot;bb CITY OF TIGARD Geotechnical Office (503) 601-8250
541
Carlson Testing, Inc. BUILDING DIVISION Salem Office (503) 345-0289
589-1252
Euene Office
Tigard Office (503) 684-3460
Daily Report of Reinforced Concrete
Client: CARING CLOSET @ TIGARD HIGH SCHOOL - ROSE MONEY
Project: CARING CLOSET ADDITION @ TIGARD HIGH SCHOOL CTI Job#: T1702294.
Address: 9000 SW DURHAM RD TIGARD OR Jurisdiction: TIGARD
CTI representative T. RUNCKEL WABO SI 02192/ACI 01366796/ICC 8685688
was on site this date Jul. 26, 2017 to perform Special Inspection for:
Permit BUP2017-00054
DFS #(s) PO Number:
SCOPE OF INSPECTION CONCRETE
1. Checked in with superintendent or client representative. 1. Mix Design approved? Yes Li No N/A
Name: SHAWN
Company: ATAT YST 2. Monitored loads arriving at job site for correct:
Mix#: 4 064 01W
2. Type of work: x Concrete x Reinforcing Slump 4±1 % Air 1.5±1.5
3. Work included: I x I Sampling x Inspection 3. Type of samples made? 4 X 8 CONCRETE CYLINDERS
4. Inspection was 'IBC' X Continuous Periodic Number of sets 1 Samples per set 4
5. Work performed: In the field n At precast shop 4. Inspected placing and consolidation of approx. 8
cubic yards of concrete.
REINFORCING Yes No N/A Location of concrete placement [to include grid lines, elevations
(floors) and drawing details]:
1. Reviewed previous inspection reports? X
2. Forms clear of debris? FOOTING/PAD FOR NEW BATH/LANDRY ROOM PER DETAILS
x 40.0, 1,.5+6/Si 1 .
3. Type, grade, size, quantity, spacing and X
condition conform?
4. Verified forms will nominally result in
hardened concrete of the required X
cross-sectional dimensions.
5. Verified location of reinforcing steel, pipes,
conduits and sleeves with respect to X
minimum concrete cover
6. Verified type and location of splices, length After samples are tested,results will follow on break report.
of contact laps, and min. diameter of bends. X
7. Verified support & anchorage of reinforcing REPORT SUMMARY
steel in the forms. X 1. Work inspected was: x Completed In progress
8. Verified structural embedments in the forms X 2. Completed work inspected was in compliance with
with regard to fabrication, quality and type.
9. Verified structrual embedments in the forms
n Approved plans and specifications u Shop drawings
with regard to weld inspection, quantity, and X RFI Design change n Submittal Li N/A
permits issued.
10. Verified cast in place anchors. Document #(s) PLANS Dated: 03/23/17
Description of structure inspected [to include grid lines, 3. Noncompliance item(s) were noted this date, details on
elevations (floors) and drawing details]: following page(s). Yes No x N/A
FOOTING/PAD FOR NEW BATHROOM/LLUNDRY ROOM PER 4. Noncompliance item(s) were reinspected this date, details
DETAILS 50.0. 1. 5+6/S1 .J . on following page(s). I I Yes No N/A
n Conform Remain in progress
Report(s) findings were discussed and left with
SHAWN
of CATALYST
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.
See additional report page(s). L Distribute attachments. Page 1 of 2
w
a
Daily Report of Reinforced Concrete For: 07/26/2017
CTI Job #: T1702294.
Project: CARING CLOSET ADDITION @ TIGARD HIGH SCHOOL
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.
Neil Shannon Reviewed By: Project Manager
Project Manager Review Date:08/01/2017
TR/KH
CC:• CARING CLOSET @ TIGARD HIGH SCHOOL - ROSE MONEY RMONEY@TT5D.K12.OR.US
CITY OF TIGARD BUILDING DIVISION - WALTER 'CHIP' BARNETT FINAL/NCL ONLY
WDY INC - DALE DILORETO DAL E@WDYI.COM
SCOTT/EDWARDS ARCHITECTURE LLP - SID SCOTT SID@SEALLP.COM
CATALYST PARTNERSHIPS - SHAWN MITCHELL SHAWN@CATALYSTNW.ORG
TIGARD-TUALATIN SCHOOL DISTRICT #23J - PHIL WENTZ PWENTZ@TTSD.KI2.OR.US
8430 SW HIJNZIKER ST,TIGARD OR-PO BOX 230997,TIGARD OR 97281
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