Special Inspection Report 1 Epoxy installationENGINEERING
civil & structural
engineering & planning
STRUCTURAL OBSERVATION REPORT
Project: McCallum Foundation and Deck Repair
Purpose: Epoxy installation
Location: 21630 98" Ave W, Edmonds, WA
Date: January 21, 2022
CG Project: 20371.10
Report: 1
Client: John McCallum
General Contractor: Davison Custom Concrete
Field Rep: Dennis Titus, PE, SE
PURPOSE AND SCOPE
A field representative of CG Engineering was on site on January 21, 2022, to observe the epoxy
installation for new concrete patio rebar dowels. While on site we met with Jim Davison from Davison
Custom Concrete.
OBSERVATIONS
At the time of the observation all of the piles had been installed and the subgrade had been prepared
for the new concrete slab. The contractor was in the process of placing the reinforcement. The
reinforcement for the slab will be doweled an epoxied into the existing house foundation.
Prior to the inspection the contractor had drilled and cleaned all holes. Each hole was cleaned again
while we were on site. The holes were cleaned with a wire brush and compressed air. The
reinforcement was spaced at 18" CIC per and all holes were at least 4" deep per SS-3. Simpson Set-XP
with an expiration date of 12/30/22 was used. The epoxy was applied with a tube dispenser and mixing
nozzle. The initial unmixed epoxy was discarded prior to beginning the epoxy injection. The
reinforcement dowels were installed per the manufacturer's instructions by twisting as they were
inserted.
EPDXY INSPECTION
Epoxy: Simpson Set-XP Adequate
Expiration: 12/30/22 Adequate
Hole Depth: 4" + Adequate
Hole Cleaning: Compressed air & wire brush Adequate
Epoxy Mixing:
Rebar installation:
Adequate
Adequate
*All epoxy installation was completed per the manufacturer's recommendations.
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DISCLAIMER
This observation is the professional opinion of CG Engineering PLLC based on the information
available during this assessment or evaluation. This report does not warrant or guarantee that all jL
conditions were discovered at the time ofthe observation. This report was prepared subject to the
standard of care applicable to professional services at the time the services were provided.
250 4th Avenue South, Suite 200
Edmonds, WA 98020
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McCallum Foundation & Deck Repair
1/21/22
CG Project No.: 20371.10 Page 2 of 3
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Photo 1— Subgrade Preparation
Photo 2 — Epoxy Expiration
2504th Avenue South, Suite 200
Edmonds, WA 98020
cwr��w�cco�w� ph.425.778.8500 1 f.425.778.5536
McCallum Foundation & Deck Repair
CG Project No.: 20371.10
1/21/22
Page 3 of 3
Photo 3 — Epoxy Installation
Photo 4 — Epoxy Installation
2504th Avenue South, Suite 200
Edmonds, WA 98020
ph.425.778.8500 1 f.425.778.5536
FOUNDATION PLAN
SCALE: 1/8" =1'-0"
0 5'-0"
ENGINEERING
4TH AVESUITE Zoo
WASHINGTON 98020FOUNDATI0N
PHONE 425) 778-SWO
McCALLUM RESIDENCE
21630 98TH AVE W
EDMONDS, WA 98020
DATE 12/21/21
PROJECT NO. 20371.10
SCALE 1/j8' - 1'-0•
ILE PLAN
- - - - - - - _ • - - � _, . ..
BY
BELEOMONDS,
HECK
CHECKED BY
SHEET
12/21/21
SECOND
FRAMING
12/ 21/ 21
McCALLUM RESIDENCE
21630 98TH AVE W
EDMONDS, WA 98020
DATE 12/21/21
SHEET
PROJECT NO. 20371.10
SCALE 1/8' - 1'-0-
ENGINEERING
2BD "TN AVE. S., SUITE 200
EDMONDS, WASHINGTON 98020
PHONE i425) 778-BS00
FOUNDATION PLAN
_ _ _ _ - - • _ _ _ _. . .. -
DRAWN BY ATD
SS'2
CHECKED BY BEL