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Home My WebLink AboutPermit Building 2008-7-29 Carlson Testing, Inc. MaIO Officf., PO Box23814 TIgard Oregon 97281 Phone (503) 684-3460 Fax (503) 684-0954 Salem Office 4060 Hud,on Ave NE Salem Oregon 9730 I rhone (503) 589-1252 Fax (503) 589-1309 Bend Offiee ro Box 7918 Bend Oregon 97708 Phone (541) 330-9155 Fax (541) 330-9163 Daily Report of Proprietary Anchors ClIent SAFEWAY STORES INC - BRIAN NORTH Project SAFEWAY STORE #0311 REMODEL - SPRINGFIELD Address 5015 MAIN STREET - SPRINGFIELD, OR JUrisdIctIon CTl representative E T WILLIAMS OBOA 374 was on Site thiS date Jul 29, 2008 to perform SpeeIallnspectIOn for rermll COM2008-00459 DFS #(5) SCOPE OF INSPECTION Checked In with supermtendent or chent representative Name RANS Company BooeD CONSTRucrION 2 InspectIOn was "IBe" [i] Contmuous D Penodlc 3 Wor!. perfonned GJ In the field 0 At precast shop 4 If shop mspeetlOn do they have fabncatlOn and QC procedures? 0 Yes 0 No GJ N/A PROPRIETARY ANCHORS Yes No N/A xl I 1 11 ReViewed prevIOus inspectIOn reports? I 2 ReViewed evaluation report? 13 Venfied manufacturer's anchor use conforms to acceptance cntena In report summary VerIfied follOWing Items meet manufacturer's publIshed mstallallon mstruetIOns 4 Ventled mlDlmum embedment depth ofthe anchors 5 Venfied mstallatIOn of the anehors 6 Verified anchor diameter 17 Venfied steel grade 18 Venfied hole diameter 9 Venfied type ofdnll bit used 10 Verified c1eanlmess of hole and anchor I I Venfied ddheslve applIeatlon v x x x x x xl xl I x I I x I Evaluation report number 5193 Name of pro duet bemg mstalled HILTI BY 150 Bateh Number 051817 L2 ExpiratIon Date 1/09 CTI Job # S0805452 SPRINGFIELD PO Number Loeatlon ofpropnetary anchors mspecled [to melude gnd lInes, elevations (floors) and drawmg details] REBAR DOWELS INTO CONCRETE FOUNDATION FOR BETROFITTING- 8 #5 REBAR- DOWELS REPORT SUMMARY Work mspected was [1J Compleled D In progress 2 Completed work mspected was m complIanee with GJ Approved plans and speelfieatIOns D Shop drawmgs D RFI D DeSign ehange D Submittal D N/A Document #(5) EMAIL Daled 7/29/8 3 NoneomplIance Item(s) were noted thiS date, details on followmg page(s) DYes D No [1J N/A 4 NoneomplIance Item(s) were remspeeled thiS date, details on followmg pagels) DYes D No [1J N/A D Conform 0 Remam m progress Report(s) findmgs were dlseussed and left with RANS of BOOCO CONSTRUCTION Based on the Code approval IS required ITom the BUlldmg OffiCial before the SPECIAL INSPECTED Items noted above ean be covered Carlson Testmg has no authonty to dIreet work of contraetors or subeontractors D See additIOnal report pagelS) D Dlstnbute attaehments Page ~of _ Dally Report of ProprIetary Anchors CTI Job #. S0805452 For 07129/2008 ProJect. SAFEWAY STORE #0311 REMODEL - SPRINGFIELD Notes ENGINEER IS GIVING APPROVAL BY EMAIL AND AND VERBAL TO USE HILTI HY 150 INTO UNRACKED CONCRETE FOOTING In some cases more than one box may be checked for a given Item on the front page Our reports pertam to the material tested/mspected only InformatIon contamed herem IS not to be reproduced, except m full, wIthout priOr authorizatIon from thiS office If there are any further questions regardmg thIS matter, please do not hesitate to contact thiS office Respectfully submItted, CARLSON TESTING, INC RevIewed By Steven Dugger Review Date 08/01/2008 EW/KMF SAFEWAY STORES INC - BRIAN NORTH TO CITY OF SPRINGFIELD BUILDING DEPARTMENT FROELICH CONSULTING ENGINEERS BOOCO CONSTROCTION INC