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OTTO ROSENAU & ASSOCIATES, INC. <br /> Geotechnical Engineering, Construction Inspection & Materials Testing <br /> PROPRIETARY ANCHOR ADHESIVE INSPECTION REPORT <br /> Report Number: PAA466411 Job No.: 24-0053 <br /> Project Name: Waterline Gym Permit: B2306-070 <br /> Project Address: 2900 Grand Avenue, Units 4, 5, Everett <br /> Inspector: Ernest Leimkuhler (WABO#: SI 01954) <br /> Client Name: CH Grand LLC Insp. Date:04/17/2024 <br /> Description / Location / Intended Use J <br /> Epoxy Anchor bolts for structural steel deck ledgers to Concrete walls <br /> Per: 9/S3.0, At: A.0/7.0-8.0, Mezzanine level <br /> Building Code&Year: 2018 IBC <br /> ❑ Reinforcing Steel All Thread <br /> Bar/Dowel Size &Quantity: Anchor Size&Quantity: 3/4" (19) <br /> Rebar Manufacturer: Type of Steel (ASTM): ❑d A-36 ❑ F-1554 ❑ A-307 <br /> Rebar Grade❑40 ❑60 [-]Other: Grade: W 36 ❑ 50 ❑ 75 ❑ Other: <br /> Type of Bar ❑A-615 ❑A-706 ❑Other: Does Contractor Need to Schedule Torque Verification? ❑d Yes ❑ No <br /> Special Ductile Quality(SDQ) Steel: Reason (If No): <br /> Anchor Length: 8" Hole Depth: 5.5" Required Embedment: 5" <br /> Hole Diameter: 7/8" Concrete Thickness: Concrete Strength: <br /> Hole Orientation: ❑Vertical Down ❑ Upwardly Inclined W Horizontal <br /> Base Material: W Normal Weight Concrete ❑ Lightweight Concrete ❑ CMU ❑ Brick ❑ Composite Deck <br /> Hole Cleaning: W Compressed Air ❑ Hand Pump ❑ Vacuum Drill Bit ❑ Other <br /> Compressed Air PSI: 150 Drill Bit(ANSI B212.15): Yes <br /> Brushed: Yes Hole Condition: W Dry ❑ Damp ❑ Water Saturated ❑ Submerged <br /> Adhesive Manufacturer/Type: Simpson Set 3G7777Expiration Date: 10/2025 ICC ESR#: 4057 <br /> Certified Installers: <br /> Weather: Indoors/dry Ambient Temperature: 55 Substrate Temperature: 56 <br /> Reference Standard(s) Used: 2018 IBC Conforms? ❑ Yes ❑ No <br /> Comments: <br /> Date: 2024.04.23 <br /> Copies to: 08:11 :25 -07'00' <br /> Client 0 Engineer ❑ Others Technical Responsibility: <br /> ❑ Owner [41 Contractor <br /> v]Architect W Building Dept Isaac Ruoff, Project Manager <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 />