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OTTO ROSENAU & ASSOCIATES, INC. <br />Geotechnical Engineering, Construction Inspection & Materials Testing <br />PROPRIETARY ANCHOR ADHESIVE INSPECTION FIELD REPORT <br />Job Number: 17-0489 Report Number: 351813 Permit Number: <br />Project: 40-56 Mold Die Rack Client: Boeing SSG <br />Address: 3600 W Casino Rd Everett Wa. Address: <br />Inspector: T Thoreson Date: 07-07-17 <br />Description/Location: Anchors for seven (7) new Die Mold Racks 40-56 Bldg. east side of existing mold racks <br />Intended Use: Anchor new Mold Racks <br />Building Code & Year: IBC 2009 <br />❑ Reinforcing Steel <br />X❑ All Thread <br />Bar/Dowel Size & Quantity: <br />Anchor Size & Quantity: 7/8" X 13" 28 ea. <br />Rebar Manufacturer: <br />Type of Steel (ASTM): X❑ 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'/4" <br />Required Embedment: 8" <br />Hole Diameter: 1" <br />Concrete Thickness: 12" <br />Concrete Strength: 4000# <br />Hole Orientation: X❑ Vertical Down ❑ Vertical Up ❑ Horizontal <br />Base Material: X❑ Normal Weight Concrete ❑ Light Weight Concrete ❑ CMU ❑ Brick ❑ Composite Deck <br />Hole Cleaning: ❑ Compressed Air ❑ Hand Pump ❑ Other: Vacuum <br />Compressed Air PSI: <br />Brushed: ❑ Yes ❑ No <br />Hole Condition: X❑ Dry ❑ Damp ❑ Water Saturated ❑ Submerged <br />Drill Bit (ANSI B212.15): ❑ Yes ❑ No <br />Approved Diamond Cored Hole: ❑ Yes ❑ No <br />Adhesive Manufacturer/Type: Hilti HY-200-R <br />Expiration Date: 04-18 <br />ICC ESR #: 3187 <br />Weather: Indoors <br />Ambient Temperature: 72 <br />Substrate Temperature: 68 <br />Adhesive Type: <br />Expiration Date: <br />ICC ESR #: <br />Weather: <br />Ambient Temperature: <br />Substrate Temperature: <br />Reference Standard(s) Used: <br />Start Time: <br />Finish Time: <br />Inspected by: <br />Comments <br />Conforms Does Not Conform <br />Is this a re -inspection? ❑ Yes ❑ No <br />Original inspection date: <br />Reviewed by: <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. <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 LT (Rev 05113) <br />