Mayes Terracon Rebar Epoxy ReportPOST -INSTALLED ANCHORS REPORT
Report Number: M7221777.0003
Service Date: 2023-01-18
Report Date: 2023-01-18
Task: General
Project
Swedish Health Edmonds MRI Suite
21601 76th Ave W
Edmonds, WA
® rerracon
General Information
Dan Lemagie, BN Builders requested Terracon be on site for Adhesive Anchor Observation of the adhesive anchors being installed by Evergreen
Concrete Cutting. Results of observation(s) performed today were reported to Dan Lemagie, BN Builders. The Terracon representative arrived at
the site at 0700 and departed at 0830.
The construction documents referenced for this observation include: Permit Set Revision 09/09/2022. Permit No. BLD2022-1221
Anchor System Information
The following adhesive types were used during today's observation:
Adhesive No. ICC Report Adhesive Lot No. Exp. Date Time Until Referenced
Full Cure
1 ESR-3187 Hilti HIT HY-200 R V3 1509201-4 05/2023 1.5 hr(s) S1.2, RFI #20
Anchor Installation
Anchor installation was observed utilizing the adhesive(s), noted above, as follows:
Adhesive Time Anchor Size Length & Spacing &
No. Installed
Locations Quantity &Type Embedment Edge Distance Status*
(in.) (in.)
1 830 (1) Utility trench infill, 2/M-N 60 #4 Rebar 24 & 6 12 & 2 Complies
* See below for more information
Holes were cleaned prior to installation by: Dustless drilling and cleaning system. Ambient Temperature during observation was 680F
Compliance
Based on our observations and testing, the post -installed anchors referenced above appear to be in general accordance with the project documents.
Q,f7V/-�
Harrington, Carl
Terracon Representative
The tests were performed in general accordance with applicable ASTM, 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.
DDM018, 04-29-22, Rev. 5 Page 1 of 1