HomeMy WebLinkAboutBuilding Field Test & Inspection Report 2010-1-6
Carlson Testing, Inc.
Bend Office
Geotechnical Office
Eugene Office"
. Salem Office
Tigard Office
(541)330-9155 Kt
(503) 601-8250
(541) 345-0289
(503) 589-1252
(503) 684-3460
Daily Report of Proprietary Anchors
Client: IL MECHANICAL INC - J:v1ARY WILIAMS
Project:' DATA CENTER EXPANSION
Address: 123 INTERNATIONAL WP.Y - SPRINGFIELD, OR . Jurisdiction:
CTI representative S. FOX OBOA 177
was on site this date Jan. 06, 2010 to perform Special Inspection for:
Permit COM 2009-01260
DFS #(s)
SCOPE OF INSPECTION
1. Checked in with superintendent or client representative.
Name: MOSES
Company: IL MECHANICAL
2. Inspection was "IBe" [i] Continuous
o Periodic
PROPRIETARY ANCHORS
Yes NoN/A
I. Reviewed previous inspection reports?
2. Reviewed evaluation report?
I : I I
Verified', follmving'items'mcet manufacturer-Is
published installation instr~ctions.
3. Verified minimum embedment depth of the
anchors.
4.Verified installation of the anchors.
5, Verified anchor diameter.
6. Verified steel grade.
7. Verified hole diameter.
g, Verified type of drill bit used,
9, Verified hole cleaning method.
10. Verified adhesive application.
] ]. Verified edge distance.
12. Verified spacing.
I ]3. Verified installation torque.
X
X
X
X
X
X
X
X
X
X
cn Job #: c0901 O'? A
SPRINGFIELD
PO.Number:
Location of proprietary anchors inspected [to include grid
lines, elevations (floors) and drawing details]:
CONTRACTOR DRILLED HOLES AND INSTALLED 1121
l/R"X.S" HTI,TI KB-TZ ANCHORS FOR THE BASE SUPPORT
OF THE CHILL8RS ON THE EXTERIOR OF THE BUILDING
PER DETAIL 4/S-001 OF THE APP~OVED STRUCTU~~L
DRAWTN(.;S. AT,T, ANCHORS WERE TOROUED TO MINIMUM 25
J:''T'/T,RS
REPORrSUMMARY
X
1. Work inspected was:. W Completed D In progress
2. Completed work inspected was in compliance with
GJ Approved plans and specifications D Shop drawings
D RFI D Design change D Submittal D N/A
Document#(s) 0909PHL Dated: 8/14/09
3. Noncompliance item(s) were noted this date, details on
following pagers). DYes D No [;J N/A
4. Noncompliance item(s) were reinspected this date, details
on following pagers). DYes D No GJ N/A
D Conform D Remain in progress
Evaluation report number & date: Report(s) findings were discussed and left with
ICC ESR 1917 MOSES
9/1/2005 of IL MECHANICAL
Name of product being installed HILTI KB-TZ
Batch Number
Expiration Date
Based on the Code, approval is required rrom the Building Official before the SPECIAL INSPECTED items noted above can
be covered. Carlson Testing has no authority to direct work of contractors or subcontractors.
D See additional report pagers).
D Distri.bute attachments.
Page _of_
Daily Report of Proprietary Anchors
en Job #: E0901042.A
For: 01/06/20101
Project:
DATA CENTER EXPANSION
Notes:
In some cases more than one box may be checked for a given item on the front page.
Our reports pertain to the material tested/inspected only. Information contained herein is not to be reproduced, except:in fl
without prior authorization from this office:Under all circumstances, the information contained in this report is provided
subject to all terms and conditions of CTI's General Conditions in effect at the time this report is prepared. No party other
than those to whom CTI has distributed this report shall be entitled to use or rely upon the information contained in tHis
~~ I
If there are any further questions regarding this matter, please do not hesitate to contact this office.
Respectfully submitted,
CARLSON TESTING, INe.
Reviewed By: Steven Dugger
Review Date: 0 I /II /20 10
SF/KMF
11 MECHANICAL INC - MARY WILIAMS
TO: CITY OF SPRINGFIELD BUILDING DEPARTMENT
KPFF
INGO.LANGE@ILMECHANICAL.COM
ROBERT RITNER
FAX/S03-227-79BO
FAX/714-832-1999
PEACE HEALTH RIVERBEND ANNEX