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Amerispec lnspections <br />REGISTERED INSPECTOR'S REPORT <br />lnspociors (s) Nsmo: JOn NeWSOm contacl rnto: 951 -21 9-4008 <br />TEST PERFORMEO <br />TYPE OF SAMPLE SLUMP OUANTITY IN SET ADDITIONAL REMARKS ON SAMPLES <br />CERTIFICATE OF COT'PLIANCE <br />I HEREBY CERII'Y THAT I HAVE INSPECIEO IO TIIE EEST OF MY X}IOWLEOC* <br />A.LL OF IHE AACA/E Rf,FIRIED WOA< U{LESS qIHERWISE NO-TEO IftAVE <br />FOUNO TIIIS IVO{d( COIIPIIES wlTH IhE APPROVED PtANS, SPECFIC IIOIIS <br />ANOAPPLICISI-E SECTIoNS OF IHE GOVERI{ITG AUIOING IAWS <br />PAGE or <br />nraE tx Tlx€ our REG HOI,RS OT s^xPt-Es <br />I2:oODm 2:0Opm 4 <br />all raaPEcnoi3laa€o ota a ItNtIUta oF a Boui! Alta, ovER a lto{na.a-ltotrRrr|rarB lla {roarloia, AraY ri€PEcTroa{ glExorac PAst rxE ioo.l l{ot i wl.t <br />E <br />^la <br />a--rlot i $llLt <br />^**r 42,4,-.-- <br />==- <br />Prol.ci gsg.rint.nd.nl <br />(L <br />OF REGISIEREO IIISPECIOR <br />lcc <br />TYPE OF <br />INSPECTION <br />REQUIREO <br />ntorcod Concr!lc <br />Tanrior Concralo <br />Conilruction <br />Mrtonry <br />B.r CailirE! <br />Conb <br />TinEJob t{o.ort6 3-12-18 <br />Stccl Alrcmbly <br />Proollrp <br />Job Addra$: 3400 W. Garry <br />Jiib Namc genr paint wharehouse Pamll No.: 101 94526 lssuod By: Sanla Ana <br />city: Santa Ana <br />Typo ol sbuctu.: storage Racks Phase 3 Archit€ct <br />Msterial D@criptbn (typr, gr8dr, 8ource): <br />Powers Wedge Anchors <br />Engincori Maresh Palkhiwala <br />Contredor: <br />Subconrraclor: RSI <br />I <br />I <br />LOCTIOX O€ WORK <br />'{SPECIEO, <br />TEST SAT'PLES IAXEIi, WORX REJECTED, JO' PROEIETTS. PR@RESE RET'ARXS. E C. <br />frcr-uoEs {tFfill Tloll AaouT aLoot r of IArERur RrcED oR (nER ( P€RfoRtaEo. rivl.a€R. TYPE I DExTrFlcrTlox <br />XOS Of rESr sAA.ftES r^IGx: Sl_Rt CTrrRA COraECIlOrlS (uGlO raADE, H.3. SOII! TOROUE) Cl€CxEO, EIC. <br />INSPECTION SUMMARY - <br />Powers Screw Anchors <br />Observed the installation and verified the torgue of new storage racks per schedule <br />and details on the approved plan. Used Powers Screw Anchors ESH 2526. Verified the <br />depth and proper torque of 40ft lbs. Schedule on sheel S2.1 and details on SCE 1 of 1. <br />Location: <br />1) Row 22 Double Row = (4) 1/2" x 4" Screw Anchor with min.3-114" emb. (Four per Plate) <br />2) Row 23 Double Row = (4) 112" x 4" Screw Anchor with min.3-114" emb. (Four per Plate) <br />Work is complete for the areas listed. <br />t{o <br />1036034 <br />AGENCYspebrer-rz{