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Report (44) N rl r O Bend Office (541)330-9155 A7 Testing, Geotechnical Office (503)601-8250 11 ' Inc. Eugene Office (541)345-0289 Salem Office (503)589-1252 Tigard Office (503)684-3460 Daily Report of Proprietary Anchors Project: „ 1 Address: _ air It" --f,. . -t >r> CTI Job#: TileeCf CTI representative r a-.x ,C,�,�,,� . , �`i , ( spector Name&Cert.No.) 'y----- was on site this date _f /� --------..-__. to perform Special Inspection for permit 0 DFS#(s) `1 T=< nf6--as . �� jurisdiction rr;,.- 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 1.Checked in with superintendent or client representative. lines,elevations(floors)and drawing details]: Company: 2(2r,,___®,i /. .f ,,,,,c4,„ r - /- '' Q' . �.fru ��� je,.-, ...14,-,•.'2.Inspection was "IBC" Continuous ©' eriodic PROPRIETARY ANCHORS ' �� r ^=w- Y f!I 4' ,1.Reviewedprevious inspectionYes No N/A _ reports? 11111111M 2.Reviewed evaluation report? [■111P111111Verified following items meet manufacturer'sREPORT SUMMARY published installation instructions. 3.Verified minimum embedment depth of the 1• Work inspected was: t. Completed 0 In progress anchors. M,. 2.Completed work inspected as 4.Verified installation of the anchors. Ella in co ,pliance with ❑ was not 5.Verified anchor diameter. MEM Ar .proved plans and specifications 6.Verified steel � Shop drawingsgrade. illi 0 RFI 0 Design change uhmittal 7.Verified hole diameter. N/A 8.Verified type of drill bit used. RAM Document#(s) S � ' Dated: _i-r_ 7 8.Verified hole of di method MOM 3.Noncompliance item(s)were noted this date,details on 9M 10.Verified adhesive application. :: following page(s). � Yes 12:r% 0 N/A 11.Verified edge distance. ■ 4.Noncompliance item(s)were reinspected this date,details 12. Verified spacing. ' w■■ on following-page(s). El Yes 13.Verified installation torque. )� No 12-'51/A IIIII El Conform 0 Remain in progress 'Evaluation report number&date: �-oReport(s)findings were discussed and left with Name of product being installed -<—___f 7-Xh of 4 -. Batch Number 1...C,r_._,?..‘..3792. Expiration Date S� -------- _� 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. Inspector Signature: / 0 See additional reportpage(s). p Distribute attachments. Page__ ___of / PropAnchors Ver.] 2/12444'' Terms: Client recognizes that construction observation and/or testing services provided by CrI are techniques which may reduce the risk of construction defects,deficiencies,or omissions arising during or after con- struction. Services performed by CTI do not constitute a warranty or guarantee of any type. Even with diligent construction monitoring and/or testing by CTI,construction defects, deficiencies, or omissions in the Contractor's work may exist.In all cases,Client and/or the Contractor shall assign the Contractor the responsibility for the quality and completeness of the work and for adhering to plans and specifica- tions. CTI's work or failure to perform same shall not in any way excuse any contractor, subcontractor, or supplier from performance of its work in accordance with the contract documents. (,,RTI will provide its professional services to Client with that degree of care and skill ordinarily exercised under similar circumstances by members of its profession.This representation is in lieu of other warran- ty or representation, either expressed or implied. It is also understood and agreed that statements made in CTI reports are observations based on technical judgments, and should not be construed to be con- clusive representations of fact. If conditions different from what are indicated in the reports come to Client's attention after receipt of the reports, it is recommended that Client contact CTI immediately to • authorize further appropriate evaluation. CPI's work shall nor include determining,supervising or implementing the means,methods,techniques, sequences or procedures of construction.CTI shall not be responsible for evaluating or reporting job con- ditions related to health,safety or welfare.