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x <br /> 20225 Cedar Valley Rd Ste 110 MAYES TESTING ENGINEERS <br /> Lynnwood,WA 98036-6365 <br /> 425-742-9360 ,Asti <br /> FIRE STOPPING OBSERVATION REPORT <br /> Report Number: M7191527.0004 <br /> Service Date: 10/17/19 <br /> Report Date: 10/22/19 <br /> Task: <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 /> ON SITE INSPECTION OF INSTALLED FIRESTOPS-ASTM E2174 <br /> INSPECTION TYPE <br /> (WITNESSED <br /> INSPECTION DOCUMENT REFERENCE INSTALLATION, <br /> LOCATION (UL LISTING OR ENGINEERING DESTRUCTIVE TESTING OR <br /> (LEVEL,GRID,ROOM,WALL OR FLOOR) JUDGEMENT) REPAIR) COMPLIANCE <br /> 1. LvI 2 floor pharmacy—Max 10"nomina UL System No.C-AJ-1149 Destructive Yes <br /> metal pipe-16 floor penetrations <br /> :. North project boundary gypsum wall <br /> penetrations from hallway side <br /> Max 7"blank holes-5 Holes UL System No. C-AJ-0070 Witness Yes <br /> For 6"Max metal conduit-1 pen, UL System No,W-L-1054 VVitness Yes <br /> Total#of Deficiencies as a percentage of the total number of firestops inspected: 0% <br /> Comments: <br /> Services: <br /> Mayes Rep: Joseph Allen <br /> Report Distribution <br /> t <br /> (1)City of Everett WA,T Budden (1)Skanska USA Building Inc,Galen Smith <br /> (1)Mayes Testing Engineers,Inc,Donna Pollard Reviewed By: <br /> (1)Mayes Testing Engineers,Inc,Todd Wirtz Timothy G. Beckerle, PE <br /> (1)Providence Health and Services,James Grafton Principal <br /> The tests were performed in general accordance with applicable ASTM,AASHTO,or DOT test methods.This report is exclusivelyforthe use of the client indicated above and shall not be reproduced except in full <br /> without the written consent of our company.Test results transmitted herein are only applicable to the actual samples tested at the location(s)referenced and are not necessarily indicative of the properties of other <br /> apparently similar or identical materials. <br /> CT0002,10.16-I3,Rev.8 <br />