Report (2) 7409 SW Tech Center Dr.Ste. 145
Tigard,OR.97223
6—ALr Ph:503-443-3799 Fax:503-620-2748
ase DAILY FIELD REPORT FOR PROPRIETARY ANCHORS
�,sTESUNG,:..INC Ir ✓ '7;
503.443.3799 Date: ' ° P t� Permit#: �..y4_ ��i�t`'����"
�� �,".',�� ,,. G^•„�.� �'i�-.,j��.,,�,.1''-...,.,..� ��X4Y--l:..4 1�,'°..d�3 `:''6�v..lt..a.�?''-, I.�:_,•� a
Continuous ❑
Periodic
Inspector/Certification # P,:� ,0 ACS Job #
Anchor Embedded in: Is this a re-inspection?: ❑ Yes []` No
Compressive Strength:' Approved plans available?: ® Yes ❑ No
HOLE DETAIUCONDITION Work acceptable per approved Yes ❑ No
plans?:
Anchor Embed
,� Hole 0: ; /,f Installation complies with
Size: � Depth: ` - manufacturer's evaluation report?: Yes ❑ No
Holes cleaned properly?: E� Yes ❑ No
LOCATION OF ANCHORS
Embedment per plans?: y Yes ❑ No G+49L�ras r r :
INSTALLATION
ESR REPORT# GRIDLINES rLlt_• G�l,x � �;? -r ✓?
/9i 7 GRIDLINES LdJ�=' k Sr��' ,�# �1t:f•�",i��
TYPE OF ANCHOR:
IS THERE AN RFI? ❑ Yes ❑ No
EPDXY TYPE: - j L1A RFI ATTACHED? ❑ Yes []' No
EXP. DATE: INSPECTION DETAILS:
> g
2
"7
jt� `..� ✓t'..1 .� t 1 ';,`i ,i'a ✓;i.:..'/a$.
0 i
Foreman notified of ❑ Yes ❑ No ❑ N/A
nonconformance items?
Foremans Name: 3J r..� L tom•, �«
ReviewedDate: cc:
Bob Brown, President Alas
VM
BB/
ACCREDITED