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51.5276 <br /> GEOT E S T I O' @k Harbor <br /> Bellingham I Arlington Oak Harborr <br /> vvww.geotest-i nc.com <br /> ADHESIVE ANCHOR INSPECTION REPORT <br /> PROJECT: 11929 Evergreen Way JOB#: 22-0851 <br /> ADDRESS: 11929 Evergreen Way, Everett, WA REPORT#: AA005 <br /> PERMIT#: B2202-020 DATE: 10/20/2022 <br /> CLIENT: Otak, Inc. PAGE#: 1 of 3 <br /> CONTRACTOR: Otak, Inc. INSPECTOR: Kevin Richardson <br /> Item(s) Inspected Location <br /> 1/2"Hilti HA-E-55(60)All Thread Anchors-Railing Anchors Blue Line Station on Evergreen Way(2782) <br /> Reference Drawing(s): Railing Base Plate Connection on Sheet F1.02 <br /> Item(s) Inspected AComments <br /> Base Material Condition Dry Concrete <br /> Drill Bit Type Carbide Tip <br /> Hole Diameter/Depth /� 5/8"/4" <br /> Hole Cleanliness Blown Out <br /> Anchor Spacing/Edge Distance /� Per Plan <br /> Anchor Type /� Hilti HA-E-55(F1554 Grade 55) <br /> Anchor Diameter/Length 1/2"/4-1/2" <br /> Anchor Embedment 4" <br /> Adhesive Type Hilti Hit HY 200-A <br /> Adhesive Expiration Date 7/2023 <br /> Adhesive ICC-ES Report [� 3963 <br /> Other ❑ <br /> The above items were conforming V Nonconforming Items(see below) ❑ <br /> Comments: GeoTest was on site as requested to provide a special inspection of All Thread <br /> anchors installed at the Blue Line Station (2782). Anchors were generally installed per the <br /> manufacturer's installation instructions and the Railing Base Plate Connection Detail on F1 .02. <br /> At several locations (see images 2 and 3), concrete spalled while drilling. The contractor <br /> discussed on-site with OTAK and is working with them on a solution. <br /> COPIES:Jeff.Massie@otak.com Reviewed by <br /> This report shall not be reproduced except in full,without the written approval of GeoTest Services,Inc. <br />