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BLD2017-1360 SPECIAL INSP POST ANCHORS - LFPOST -INSTALLED ANCHORS REPORT MAYES TESTING ENGINEERS Alrerracan co,,A,, Report Number: M7171821.0001 Service Date: 11/03/17 Report Date: 11/09/17 20225 Cedar Valley Rd Ste 110 Lynnwood, WA 98036-6365 425-742-9360 Client Project Providence Health and Services Swedish Edmonds Pharmacy Attn: Camilla Yamada 21601 76th Ave W PO Box 24883 Edmonds, WA Seattle, WA 98124 Proiect No.: M7171821 Permit No.: BLD2017-1360 Samples: N/A Weather: Indoors Observed the epoxy grouting of #4 and #5 reinforcing steel dowels for the new slab and stairs at the north end of corridor E 1350.001 per detail A/S2. 1. Simpson SET-XP epoxy was used (lot #257D61 OD, expiration 05/16/19). To the best of our knowledge, the items inspected today are in conformance with approved plans and specifications. Services: Special Inspections / Materials Testing Mayes Testing Engineers Rep.: David Mercado Reported to: Sellen Construction Co., Inc. Contractor: Sellen Construction Co., Inc. Report Distribution: (1) Providence Health and Services, (1) City of Edmonds WA, Leif Bjorback Camilla Yamada (1) Mayes Testing Engineers, Inc, Jill (1) Mayes Testing Engineers, Inc, Rouse Todd Wirtz (1) Sellen Construction Co, Barry Strand Reviewed By: RoCe6ardner bert Gardner Senior Project Field Manager The tests were performed in general accordance with applicable ASTIM, AASHTO, or DOT test methods. This report is exclusively for the use of the client indicated above and shall not be reproduced except in full without the written consent of our company. Test results transmitted herein are only applicable to the actual samples tested at the location(s) referenced and are not necessarily indicative of the properties of other apparently similar or identical materials. CTOOO 1, 10- 16-13, Rev. 10 Page 1 of I MAYES TESTING ENGINEERS Alrerracon COMPANY Photo Attachment Page Project Name: Swedish Edmonds Pharmacy Date: 11/03/17 Project No.: M7171821 Figure 1. Hole cleaning in progress. Figure 3. Epoxy grouting in progress. Figure 2. Epoxy used. Figure 4. Area of work. Photo Attachment Page 1 of 1