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OTTO ROSENAU & ASSOCIATES, INC. <br />Geotechnical Engineering, Construction Inspection & Materials Testing <br />PROPRIETARY ANCHOR ADHESIVE INSPECTION REPORT <br />Job Number: <br />17-0489 Report Number: <br />351813 <br />Permit Number: <br />Project: <br />Boeing — Bldg. 40-56 Mold Die Racks <br />Client: <br />Boeing Shared Services Group <br />Address: <br />Building 40-56, Col 1369, Everett <br />Address: <br />PO Box 3707 M/C 6X-AA, Seattle <br />Inspector: Terry Thoreson Date- 7/7/2017 <br />Description/Location: Inspected the epoxy grouted installation of (28) 7/8" diameter x 13" long all thread anchor bolts for seven (7) <br />new die mold racks at the 40-56 Bldg. located at the east side of existing mold racks- The inspected work was <br />found to be done as per approved project documents. <br />Intended Use: Anchor new mold racks Building Code & Year: IBC 2016 <br />❑ Reinforcing, Steel <br />0 All T . read- <br />Bar/Dowel Size & Quantity: <br />Anchor Size & Quantity: 7/8"x13" (28) <br />Rebar Manufacturer: <br />Type of Steel (ASTM): ® A-36 ❑ F-1554 ❑ A-307 <br />Grade: ❑ 36 ❑ 50 ❑ 75 ❑ Other: <br />Rebar Grade: ❑ 40 ❑ 60 ❑ Other: <br />Type of Bar: ❑ A-615 ❑ A-706 ❑ A-775 ❑ Other: <br />Special Ductile Quality (SDQ): ❑ Yes ❑ No <br />Anchor Length: 13" <br />Hole Depth: 8'/a" <br />Required Embedment: 8" <br />Hole Diameter: 1" <br />Concrete Thickness: 12" <br />Concrete Strength: 4000 psi <br />Hole Orientation: ® Vertical Down ❑ Vertical Up ❑ Horizontal <br />Base Material: ® Normal Weight Concrete ❑ Light Weight Concrete ❑ CMU ❑ Brick ❑ Composite Deck <br />Hole Cleaning: ❑ Compressed Air <br />❑ Hand Pump ❑ Other: <br />Compressed Air PSI: <br />Brushed: ❑ Yes ❑ No <br />Hole Condition: ® Dry ❑ Damp ❑ Water Saturated ❑ Submerged <br />Drill Bit (ANSI B212.15): ❑ Yes. ❑ No <br />Approved Diamond Cored Hole: ❑ Yes ❑ No <br />Adhesive Type: Hilti HY 20OR <br />Expiration Date: 412018 <br />ICC ESR #: 3187 <br />Weather: Indoors <br />Ambient Temperature: 72" <br />Substrate Temperature: 68° <br />Comments <br />Reference Standard(s) Used: Conforms X Does Not Conform <br />Copies to: <br />Client Engineer Others �' 01' <br />X Owner X Contractor Technical Responsibility: <br />Architect X Building Dept. alte ansen, 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 report, <br />except in full, without written permission from our fine is strictly prohibited. <br />6747 M.L. King Way S., Seattle, Washington 98118 — Phone (206) 725A600 or 1-888-OTTO-4-US — Fax (206) 723-2221 <br />Form No.: ADMIN-86-02 (Rev. 05113) <br />r <br />