SIDF_0742557-11_1.rev_1Page 1 of 1 Report No: SIDF:0742557-11/1 Special Inspection Daily Field Report Issue No: 1 Professional Service Industries, Inc. 10025 South Tacoma Way, #H1 Tacoma, WA 98499 Phone: (253)
589-1804 Fax: (253) 589-2136 Project: No: AMERICAS CREDIT UNION YELM WA Client: AMERICAS CREDIT UNION PO BOX 33338 FT. LEWIS, WA 98433 These test results apply only to the specific locations
and materials noted and may not represent any other locations or elevations. This report may not be reproduced, except in full, without written permission by Professional Service Industries,
Inc. Approved Signatory: Donald Miller (Special Project Manager) Date of Issue: 10/11/2011 CC: DOUG PALMER, GARY CARLSON, JOHN BARTHELD, KATHY DEGMAN, MARY TEXIDOR, RICK ADAMS Date:
10/7/2011 General Contractor: Permits: Weather: Cloudy Type of Inspection Performed Reinforced Concrete Structural Masonry High Strength Bolting Fireproofing New Inspection Re-Inspection
Reinforcing Steel Soils Welding Other Standby Time: Field Observations & Comments Spe?????cial Inspection Continuous Periodic Location(s)/Item(s): Gridline B BTWN 1 & 9; grid 9/B-H;
1/F-J; J/1-8 HD-1 and HD-4 at vault. Referenced Details/Drawings: S2.1 details 14, 17 Remarks: PSI on site today to witness the install the HD-1 and HD-4 at above locations. The holes
were clean of all dust and debris. They were blowed out using compressed air. The ¾” all thread was embedded to 8” and the 5/8” all thread were embedded at 10”. The epoxy used was Simpson
strong -tie Set-XP22 lot # 049E154E with an expiration date of 07-2013. All holes will filled per the manufactures directions. To the best of PSI’s knowledge, the work inspected to the
approved construction documents are: Conforming Non-Conforming Inspector: Don Miller Inspector Cert No.: Jobsite Representative: