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OTTO ROSENAU & ASSOCIATES, INC. <br /> Geotechnical Engineering, Construction Inspection & Materials Testing <br /> PROPRIETARY ANCHOR ADHESIVE INSPECTION REPORT <br /> Report Number: PAA460774 Job No.: 24-0053 <br /> Project Name: Waterline Gym Permit: B2306-070 <br /> Project Address: 2900 Grand Avenue, Units 4, 5, Everett <br /> Inspector: Joshua Gray(WABO#: SI 02288) <br /> Client Name: CH Grand LLC Insp. Date:01/30/2024 <br /> Description / Location / Intended Use <br /> Onsite to inspect the installation of epoxy grouted reinforcing steel into existing concrete foundation and column for the <br /> over framing retaining wall(s) and slab located at the entrance of the bldg. around the perimeter of the existing ramp. <br /> All work was found to satisfy the requirements of S2.0 and S5.0 of the approved plans <br /> Building Code&Year: IBC 2018 <br /> Reinforcing Steel ❑ All Thread <br /> Bar/Dowel Size &Quantity: #4 (124) Anchor Size&Quantity: <br /> Rebar Manufacturer: Cascade Type of Steel (ASTM): ❑ A-36 ❑ F-1554 ❑ A-307 <br /> Rebar Grade❑40 ❑60 ❑Other: Grade: ❑ 36 ❑ 50 ❑ 75 ❑ Other: <br /> Type of Bar DA-615 ❑d A-706 ❑Other: Does Contractor Need to Schedule Torque Verification? ❑ Yes W No <br /> Special Ductile Quality(SDQ) Steel: Yes Reason (If No): <br /> � 1 <br /> Anchor Length: 1' - 3' Hole Depth: 3"-4" Required Embedment: 3"-4" <br /> Hole Diameter: 5/8" Concrete Thickness: Existing Concrete Strength: Existing <br /> Hole Orientation: ❑Vertical Down ❑ Upwardly Inclined ❑ Horizontal <br /> Base Material: ❑Normal Weight Concrete ❑ Lightweight Concrete ❑ CMU ❑ Brick ❑ Composite Deck <br /> Hole Cleaning: ❑Compressed Air ❑ Hand Pump ❑ Vacuum Drill Bit ❑ Other <br /> Compressed Air PSI: 90 Drill Bit(ANSI B212.15): Yes <br /> Brushed: Yes Hole Condition: W Dry ❑ Damp ❑ Water Saturated ❑ Submerged <br /> Adhesive Manufacturer/Type: Simpson Set 3G Expiration Date: 10/23/2025 ICC ESR#: 4057 <br /> Certified Installers: N/A <br /> Weather: Indoors Ambient Temperature: 62 Substrate Temperature: 59 <br /> Reference Standard(s) Used: Conforms? W Yes ❑ No <br /> Comments <br /> Date: 2024.02.01 <br /> Copies to: 13:19:24 -08'00' <br /> ❑� Client ❑V Engineer ❑ Others Technical Responsibility: <br /> ❑ Owner ❑d Contractor <br /> ❑d Architect Isaac Ruoff, Project Manager <br /> ❑d Building Dept <br /> This report applies only to the items tested or reported and is the exclusive property of Otto Rosenau&Associates, Inc. Reproduction of this <br /> report except in full,without written permission from our firm is strictly prohibited. <br /> 6747 M.L. King Way S.,Seattle,Washington 98118—Phone(206)725-4600—Fax(206)723-2221 <br /> Form No.:ADMIN-86-04(Rev 01124) Page 1 of 1 <br />