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OTTO ROSENAU&ASSOC /ES, INC. <br /> PROPRIETARY ANCHOR ADHESIVE INS T N REPORT <br /> prero"-- 77842 <br /> Job Number: <br /> „ <br /> Project: 1 I 4. Client <br /> Address: s „-- — Contractor <br /> , <br /> Inspector = , Date: 6 /sc.- ;IC I 6 r <br /> sp, 3.4. ,mairk\wogl'v;rrf:;,:fi-AA&ftfTitfi, tre4 wrog,tewt4,' mot;„ <br /> -,taitra ught,„:;107 „A,74 4.11a rizifitubt44,,147 kfr <br /> aiY <br /> 4 <br /> .0, <br /> Intended Use: ker Building Code&Year: il{) 5 <br /> [7,7174,57$761115576--.0-445117a454. .,ziwnw.77m3.1 <br /> ,„“ <br /> Bar/Dowel Size&Quantity: Anchor Size&Quantity: h/ 41, <br /> Rebar Manufacturer: Type of Steel(ASTM): 0 A-36 0 F-1554 0 A-307 <br /> Rebar Grade: 0 40 0 60 0 Other: Grade: 0 36-0 50 0 75 0 Other: <br /> Type of Bar: 0 A-615 0 A-706 0 A-775 0 Other: <br /> Special Ductile Quality(SDQ): 0 Yes 0 No <br /> LiTtl-7,,11.ST:iaatugxfAkfeimikztw,!,-4 Irk yrisgraggiggemomq <br /> Anchor Length: Cr Hole Depth: 5' Required Embedment: <br /> Hole Diameter: 3 Concrete Thickness: Concrete Strength: 5•1 ° ° <br /> Hole Orientation: 0Vertical Down 0 Vertical Up 0 Horizontal ?, <br /> Base Material: 01\lormal Weight Concrete 0 Light Weight Concrete 0 CMU 0 Brick 0 Composite Deck <br /> Hole Cleaning: El Compressed Air 0 Hand Pump 0 Other: ComPressed Air PSI: [ <br /> Brushed: El'Yes 0 No Hole Condition: Et Dry 0 Damp 0 Water Saturated 0 Submerged <br /> Drill Bit(ANSI B212.15): 0Yes 0 No Approved Diamond Cored Hole: 0 Yes allo <br /> Adhesive Manufacturer/Type: Aj. ft "1 Expiration Date: 0 k ICC ESR#: <br /> Weather: Ambient Temperature: Ls,li,t 1,;` Substrate Temperature: 5- <br /> RE174143taikw-it::7,SET 1,41414,4441,.31314.;i3 %%IP 7.a,V,:lkn MI-141.zr fuzge,i-rImamita <br /> iLLY 4LVY• ...estw-,f <br /> - <br /> 71ErNlikAtigill=11111.111.111111111 *MESIVI74;170,41'""41111 <br /> , • <br /> Is this a re-inspection? _0 No 0 Yes-Originalinspection,date: <br /> • <br /> Inspected by: - Reviewed by: <br /> Start Time: Finish Time: <br /> This report applies only to the items tested or reported and is the exclusive properiy,of Otto Rosenau&Associates,Inc. Reproduction of this report, <br /> except in full,without written permission from our firm is strictly prohibited. <br /> Page of <br /> 6747 M.L.King Way S.,Seattle,Washington 98118-Phone(206)725-4600 or 1-888-OTTO-4-US-Fax(206)723-2221 <br /> Form No.:INSP-86-02(Rev 05/13) <br />