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MAYES TESTING ENGINEERS <br /> FIRE STOPPING OBSERVATION REPORT ,1 < <br /> Report Number: M7191527.0004 <br /> Service Date: 10/17/19 20225 Cedar Valley Rd Ste 110 <br /> Report Date: 10/22/19 Lynnwood, WA 98036-6365 <br /> 425-742-9360 <br /> Client Project <br /> Providence Health and Services Providence Everett MC Colby Campus Pharmacy <br /> Attn:Accounts Payable 1700 13th St <br /> 600 Broadway Ste 304 Everett, WA <br /> Seattle, WA 98122 <br /> Project No.: M7191527 <br /> Permit No.: B1905-020 Weather: Indoors <br /> Samples: N/A <br /> On site for firestop penetrations through the pharmacy concrete floor and through the fire-rated project north <br /> boundary wall from the hallway side. Performed 2% destructive testing on the floor penetrations and witnessed <br /> 10% of the wall penetration fire stop seals, per ASTM and UL specifications. The penetrations were visually <br /> inspected, and were sealed using Hilti Firestop One Max caulk and rock wool as required. See today's Firestop <br /> Field Report (attached). <br /> Verified the inside wall conduit draft penetration was sealed with the Hilti Firestop One Max in pharmacy at grid <br /> lines D/3.5 and the (5) dampered ducts penetrating the north boundary wall were sealed with sheet metal flanging <br /> around duct and screwed to wall. <br /> To the best of our knowledge, the items inspected today are in conformance with approved plans and <br /> specifications. <br /> Services: <br /> Mayes/Terracon Rep.: Joseph Allen <br /> Reported to: Skanska USA <br /> Contractor: Skanska USA <br /> Report Distribution: <br /> (1)City of Everett WA,T Budden (1)Mayes Testing Engineers,Inc, <br /> Donna Pollard <br /> (1)Mayes Testing Engineers,Inc, (1)Providence Health and Services, Reviewed By: <br /> Todd Wirtz James Grafton <br /> (1)Skanska USA Building Inc,Galen Timothy G. Beckerle, PE <br /> Smith <br /> Principal <br /> The tests were performed in general accordance with applicable ASTM,AASHTO,or DOT test methods. This report is exclusively for the use of the client <br /> indicated above and shall not be reproduced except in full without the written consent of our company. Test results transmitted herein are only applicable to <br /> the actual samples tested at the location(s)referenced and are not necessarily indicative of the properties of other apparently similar or identical materials. <br /> CT0001,10-16-13,Rev.10 1' � I�� <br />