inspection report 1520zc) �g - L5 ,),6
Gf OTEST
1.888251S276
Bellingham I Arlington, Oak Harbor
w,A,a geotest•inc.com
ADHESIVE ANCHOR INSPECTION REPORT
PROJECT: Cook Residence JOB #: 20-0669
ADDRESS: 7412 176th Street SW, Edmonds, WA REPORT #: AA001
PERMIT #: BLD 2019-1520 DATE: 6/30/2021
CLIENT: Cook, Mike and Barbara PAGE #: 1 of 2
CONTRACTOR: N/A INSPECTOR: Gunnar Sterlington
Item(s) Inspected
Location
All Thread Hold Down
SE Corner of Main Floor
Reference Drawing(s): Approved Drawings
Item(s) Inspected
Comments
Base Material Condition
Clean Concrete
Drill Bit Type
/�
1" Roto Hammer Drill
Hole Diameter/Depth
1" X 18"
Hole Cleanliness
Blow Brush Blow
Anchor Spacing/Edge Distance
[y]'
per plan
Anchor Type
All Thread
Anchor Diameter/Length
7/8" X 48"
Anchor Embedment
18"
Adhesive Type
Set-3G22N
Adhesive Expiration Date
8/18/22
Adhesive ICC-ES Report
4057
Other
The above items were conforming Se Nonconforming Items (see below) Lj
Comments: GeoTest was on -site as requested to observe the installation of a single all thread
hold down. The adhesive was placed in conformance with the manufacturer's instructions and
approved drawings.
COPIES: mikek@advantage-contraclors.com Reviewed by
This report shall not be reproduced except In full, without the written approval of GeoTest Services, Inc.
0
ADHESIVE ANCHOR INSPECTION REPORT
18882515276
B=liingham Arlington Oak Harbor
VJVl N.geotest nCCo—
PROJECT: Cook Residence JOB #: 20-0669
CLIENT: Cook, Mike and Barbara REPORT #: AA001
CONTRACTOR: N/A PAGE #: 2 of 2
Used Epoxy