Report (32) 107.9.5? sw
n' / ug r � Bend Office (541) 330-9155
/"' Geotechnical Office (503) 601-8250
Carlson TestiEugene Office (541) 345-0289
ng, Inc• Salem Office (503) 589-1252
Tigard Office (503) 684-3460
Daily Report of Proprietary Anchors
Client: FEINAUER & SONS LLC - BRET FEINAUER
Project: KAHN RESIDENCE CTI Job#: T1906812.
Address: 11100 SW WALNUT ST TIGARD OR Jurisdiction: TIGARD
CTI representative K. JORDISON OBOA 1030/WABO SI 01967,WABO 3373/ACI 01133121/ICC 8008055
was on site this date may. 15, 2019 to perform Special Inspection for:
Permit MST2019-00096
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.
Name: BRET OBSERVED INSTALLATION OF 7 PIECE OF 5/8"
Company: FEINAUER & SONS LLC DIAMETER THREADED ROD THREE PIECE FOR HD'S AND
THREE FOR ANCHOR BOLTS. THREADED ROD WAS
2. Inspection was "IBC" Continuous (� Periodic
� INSTALLED PER EMAIL FROM ENGINEER OF RECORD
(5-9-19) WITH 12" EMBED.
PROPRIETARY ANCHORS
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. g 1. Work inspected was: Completed E In progress
4.Verified installation of the anchors. x 2. Completed work inspected was in compliance with
5. Verified anchor diameter. x --
6. Verified steel grade. x x Approved plans and specifications I I Shop drawings
7. Verified hole diameter. n RFI nDesign change r Submittal n N/A
x
8. Verified type of drill bit used. x Document #(s) NAVA PLANS Dated: 3-22-19
9. Verified hole cleaning method. x 3. Noncompliance item(s) were noted this date, details on
10. Verified adhesive application. x following page(s). E Yes 0 No ® N/A
11. Verified edge distance. x
12. Verified spacing. x 4. Noncompliance item(s) were reinspected this date, details
13. Verified installation torque. X on following page(s). Yes No N/A
Conform Remain in progress
Evaluation report number & date:
ESR 2508 Report(s) fmdings were discussed and left with
EXPIRES 6/2020 BRET
of FEINAUER & SONS LLC
Name of product being installed SIMPSON STRONG-TIE SET-XP
•
Batch Number 1000018113
Expiration Date 7/21/20
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.
fl Sec additional rope,, pagc(s).--- E Distribute uttachmonte,
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