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._' OTTO ROSAU& ASSOCIATES, INC. <br /> PROPRIETARY ANCHOR ADHESIVE INSPECTION REPORT 339767 <br /> Job Number: ,n Permit Num.- <br /> , a <br /> ;F r,., ,,. ,� .�., ,�'`;� ...w-. � ' x�urn, :.. ,. .. . . _.., �.." -.: . - - � .. ,• <br /> • <br /> Project: "r' ,�, .'^ t ,+ ,; �.z� �' y - / I v a <br /> Address: ` '= ` 31-'^ /'2/ J/ f!' r' Contractor: /j4,9 ' �i <br /> Inspector: ./ 1'"le <br /> /^ c':tJ iff""r.�f a' Date: �" (/J j/ 7 <br /> , 60/d. iz,✓ki �1t <br /> c ` * ;i< ",i.'( <br /> t�J C! '-'-C2 i <br /> s` <br /> Intended Use:/ I ,5 °/'f `12 Building Code&Year. <br /> Bar/Dowel Size&Quantity: Anchor Size&Quantity: 7 ./ <br /> Rebar Manufacturer: Type of Steel(ASTM): AA-36 ❑ F-1554 ❑A-307 <br /> Rebar Grade: ❑40 ❑60 ❑ Other: Grade: El 36 ❑ 50 El 75❑ Other: <br /> Type of Bar: ❑A-615 El A-706 ❑A-775 El Other: <br /> Special Ductile Quality(SDQ): ❑Yes ❑ No <br /> ri e n �u rs 3 <br /> Anchor Length: / Hole.D.epth:,• , ' , Required Embedment: <br /> Hole Diameter: //r Concrete Thickness: Concrete Strength: ? <br /> Hole Orientation: Vertical Down ❑Vertical Up ❑ Horizontal <br /> Base Material: `j Normal Weight Concrete` ❑ Light Weight Concrete El CMU ❑ Brick ❑ Composite Deck <br /> Hole Cleaning: 'Compressed Air ❑'"Hand Pump ❑ Other: Compressed Air PSI: ?cam <br /> Brushed: ]Yes ❑ No Hole Conditio•. Ain ❑Water Saturated 0 Submerged • <br /> Drill Bit(ANSI B212.15): J ']`Yes " ❑ No Approved Diamond Cored H le: ❑Yes / ]°No <br /> Adhesive Manufacturer/Type:.5i,w, ,;.r 11 i Expiration Date:/ Alf AeL-c,,-4 ICC ESR#: .5 <br /> Weather: Y,,/" Ambient Temperature: _re,CI Substrate Temperature: ..S*V".1 <br /> r <br /> REf <br /> w s � > rw <br /> - _ s <br /> ..:. _ <br /> Is this a re-inspection? , No ❑Yes-Original ins ion date: <br /> !s l^2 <br /> Inspected by: ti' Reviewed by: <br /> Start Time: Finish Time: <br /> This report applies only to the items tested or reported and is the exclusive property of Otto Rosenau&Associates,Inc. Reproduction of this report, <br /> ,except in full,without written permission from our firm is strictly prohibited. / L <br /> Page 1 of 3 7 2 6 i <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 />