3-27-23 Epxy SI reportPage 1 of 2
QK=an&Associates, Inc.
Geotechnical Engineering • Environmental Engineering
Construction Testing and Inspection
DATE: 3/9/2023
Field
Report NO.: 09623116392023MP
Set Count: CONTRACTOR:
PROJECT #: 09623116 PERMIT #:
PROJECT: Gary Residence INSPECTOR: Madhab Paudel
LOCATION: 855 Dayton St. JURISDICTION: City of Edmonds
KA P.M.: Jeff Mercer WEATHER: Partly Cloudy TEMP: 39' F
A Krazan and Associates, Inc. representative was on site today to inspect the adhesive anchor installation -epoxy.
Upon arriving on site met with contractor. Location & design noted. Contractor drilled the total eight (8) holes
horizontally on existing building wall & slab @ north side of building and installed #4 dowels with minimum
embedment 4" with epoxy. All holes were cleaned with the appropriate wire brush and air compressor. Epoxy used
was SIMPSON Strong -Tie SETAP with an expiration date of 05/02/2024. An adequate amount of epoxy was used
to completely encapsulate the embedded portion of the anchor. All anchors were installed in accordance with the
Manufacturers Printed Installation Instructions.
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Contractor did epoxy on mark area on plan drawing
Offices Serving the Western United States
M
J4 WKL a 24' OND
(4 QW) W/ W
'SET-W am ram'
Lynnwood (425) 485-5519 • Poulsbo (360) 598-2126 • Tacoma (253) 939-2500
The information provided on this report is prepared for the exclusive use of the client. This report may not be reproduced in any format without the written permission of the client and Kmm & Associates. T1us report
indicates our inspectors observation and testing results based on site conditions and contractor activities. This information is subject toreview prior to final submittal. By signing this report, our inspector does not accept
responsibility for validity of results. The same information has been provided by others on site. The test results apply only to the specific locations, and items inspected or tested
Page 2 of 2
QKmwi&Associates, Inc. Field
Geotechnical Engineering . Environmental Engineering Report NO.; 09623116392023MP
Construction Testing and Inspection
N
b`
Reviewed By: VV
ASTM Test M Asset Number(s):
To the best of my knowledge, the above WAS performed in accordance with the approved plans, specifications and
regulatory requirements.
Su erintendent/Re resentative: Technician:
Madhab Paudel
Offices Serving the Western United States
Lynnwood (425) 485-5519 - Poulsbo (360) 598-21126 • Tacoma (253) 939-2500
The information provided on this report is prepared for the eacIsolve me of the client This report may not be reproduced in any format without the written permission of the client and Kravan & Associates. This report
indicates our inspectors observation and testing results based on site conditioner and contractor activities. This infonation is subject to review prior to final submittal. By signing this report, our inspector does not accept
responsibility for validity of results. The same information hu bow Dt"Ided by others on site. The test results apply only to the specific locations, and items inspected or tested.