Report (69) ci,2°
7409 SW Tech Center Dr.Ste. 145
q; 'e..• Tigard,OR.97223
sru"L' Ph:503-443-3799 Fax:503-620-2748
411=n 'E1E DAILY FIELD REPORT FOR PROPRIETARY ANCHORS
0113
TESTING, INC
503.413.3799 Date: 5/1/17 Permit#: BUP2017-00076
ENGINEERED PRODUCTS a PAPE TYREE OIL INC
COMPANY Continuous ► I 16200 SW 72ND AVE
9800 40TH AVE S. TIGARD,OR 97224
SEATTLE,WA 98118 Periodic / PO#82397
Inspector/Certification# Chris Brown Cert#WABO SI 02203 ACS Job# 17-6956-14
Anchor Embedded in: Concrete Is this a re-inspection?: J Yes 0 No
Compressive Strength: EXISTING UNKNOWN Approved plans available?: 0 Yes D No
HOLE DETAIL/CONDFT1ON Work acceptable per approved Yes D No
plans?:
AnchorEmbed
Size: 1/2" Hole 0: 1/2" 3 Y." Installation complies with
Depth: manufacturer's evaluation report?: Z Yes No
Holes cleaned properly?: 0 Yes 0 No
LOCATION OF ANCHORS
Embedment per plans?: n Yes 0 No GRIDLINES Footing connection for baseplate to existing concrete
INSTALLATION GRIDLINES
ESR REPORT#
ESR-1917 TZ CARBON&STAINLESS in CONCRETE GRIDLINES
ANCHOR TYPE: WEDGE ANCHOR
IS THERE AN RFI? LI Yes No
EPDXY TYPE: N/A
RFI ATTACHED? LI Yes 0 No
EXP. DATE: NA
INSPECTION DETAILS:
Image Description:
ACS representative arrived on site to inspect installation of%"Hilti Kwik
Bolt TZ wedge anchors into existing concrete slab with 3-'/e"minimum
embedment using(2)two anchors per base plate per notes and
drawings on page 1 of the approved plans. A torque test was performed
at 40 ft/lbs per ICC-ESR 1917.
The work performed appears to be in conformance with notes on page 1
of the approved plans and the manufactures installation procedures. No
known revisions.
Foreman notified of ❑ Yes 0 No Q N/A
nonconformance items?
Foremans Name:
Reviewed eb Date: cc:
05-02-2017 Brian Ferrick
Bob Brown,President
BB/CB ,'; NY 0 2 2017
ACS-1157 ACCREDITED