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Home My WebLink AboutBLD10-004CITY OF PORT TOWNSEND PERMIT ACTIVITY LOG PERMIT # 12L1D10 ~O OH DATE RECEIVED ©\- OW 20)0 SCOPE OF WORK: M2) Sune DATE ACTION INITIALS (204-10 | ENTERED INTO CHET MY) \-\\-10 _ | CHECKED FOR COMPLETENESS Mu \-ZS8-/o_|PLOnN Kevieu)y Meme bonek Elm T. dumock | se ght 2 Ploun. yeurus complete ~ See conditions : Vire Sprnkles te be deterred Submitter ( Lil ( Pec ure. Separite permit fey Sprinklers ee = See Clas badVlidee) mend Joan. “Tom Aumock- {| r1 vo “LOM AUMoCkK waa large AT RV Plans in +tredS area — \ijio fs be Tocaked wien the Wose tak - 0 Sw Zoning: cox = Setbacks OK? Klo ch ange w oot Ea ‘aun Lot Size: Building Size: Lot Coverage: FAR OK? Height OK? Parking OK? Critical Area? Demo? Historic Rev? N : Notice to Title? NVO Lots of Record? Ni Thomas L. Aumock Consulting Fire Code Inspector 2303 Hendricks Street, Port Townsend, WA 98368 (360) 385-3938 Email: taumock@cablespeed.com —_ Fax: (360) 643-0272 PLAN REVIEW MEMORANDUM To: Scottie Foster, City of Port Townsend Development Services Department Fr: Thomas L. Aumock, Consulting Fire Code Inspector, East Jefferson Fire & Rescu Dt: 27 January 2010 Re: |BLD10-04 Jefferson General Hospital Remodel for MRI Suite Ce: None I am in receipt of the set of plans for the above-referenced proposal from your office, and I have reviewed the proposal with the International Fire Code [I.F.C.], 2006 Edition and Washington State Amendments, and applicable N.F.P.A. code sections. The following constitutes this plan examiner’s findings and determinations based upon the plans of record submitted, and site inspection conducted this date. Findings & Determinations: 1. The proposal was reviewed as a three-story mixed occupancy with the main floor work area for the MRI suite as a Group B occupancy. 2. An automatic fire suppression system (sprinklers) is required for this work area from the MRI unit manufacturer. a. The automatic fire sprinkler system shall be designed, installed, and certified by a licensed technician (W.A.C. 212-80) using the design provisions of NFPA 13 and related sections. b. The automatic sprinkler system shall be inter-tied with the automatic fire alarm system. 3. An automatic fire detection system [detectors] exists in the corridor and is consistent with [F.C. Section 907. 4. Fire extinguisher placement shall meet or exceed IFC Section 906 and NFPA Standard 10. 5. During demolition and/or construction, the proposal is subject to general precautions against fire provisions of Chapter 14 of the I-F.C. and related sections. Any other applicable or relevant sections of said Code not covered herein shall nonetheless apply to this proposal. 1.0 hours time was logged in the initial site inspection, plan review, and report for this proposal. It is the recommendation of this consulting fire code inspector that the proposal be approved subject to the aforesaid requirements of the International Fire Code. ran), & ASSOCIATES, INC. GEOTECHNICAL ENGINEERING ¢ ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING & INSPECTION June 22, 2010 Project No.: 106-10051 Mr. Fred Slota City of Port Townsend 250 Madison Street Port Townsend, WA 98368 RE: _ Final Letter Regarding Special Testing & Inspection Permit No.: BLD10-004 Jefferson Healthcare TI MRI / Port Townsend, WA Dear Mr. Slota: In accordance with our client’s request and authorization, we have performed special testing and inspection services for the above referenced project. The special inspections for this project were: Special Inspection Required Performed Structural Steel: Welding Bolting Reinforced Concrete Structural Masonry Expansion/Epoxy Anchor Bolts KI N I X I X X NK I N I X X X To the best of our knowledge, all work and noted deficiencies have been tested and/or inspected and have been found to be in accordance with the approved plans and specifications. If you have any questions, or if we can be of further assistance, please do not hesitate to contact our office at (360) 598-2126. Respectfully submitted, KRAZAN & ASSOCIATES, INC. Jeffrey | be Construction Services Manager Poulsbo Division ECEIVE - | JMB/md | . CITY OF PORT TOWNSEND cc: Dana Michelson — Jefferson Healthcare DSD Bob Miller-Coates Design Larry Snow-Andersen Construction With Offices Serving The Western United States 20714 State Hwy. 305 N E Ste. 3C ¢ Poulsbo, Washington 98370 ¢ (360) 598-2126 ¢ Fax: (360) 598-2127 42KkKrazan & ASSOCIATES, INC. GEOTECHNICAL ENGINEERING ¢ ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING & INSPECTION June 17, 2010 KA Project No.: 106-10051 Building Permit No.: BLD10-004 Ms. Dana Michelson Jefferson Healthcare 834 Sheridan Avenue Port Townsend, WA 98368 RE: Jefferson Healthcare Tenant Improvement MRI Port Townsend, WA Dear Ms. Michelson: In accordance with your request and authorization, the following test data are presented on the following reports, which are enclosed: April 29, 2010 Cylinder Report No. 35345 — 28 Day Break Referenced concrete reports and compressive strength data will be mailed following 28-day tests, if applicable. If you have any questions, or if we can be of further assistance, please do not hesitate to contact our office. Respectfully submitted, Bor Se, Penn Seely, Laboratory Manager Peninsula Division PS: md Enclosures CC: City of Port Townsend — Fred Slota With Offices Serving The Western United States 1230 Finn Hill Rd NW Ste. A ¢ Poulsbo, Washington 98370 e (360) 598-2126 © Fax: (360) 598-2127 Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-10051 Cyl. Code P17717 Pour Date 4/29/2010 Report No. 35345 Weather CLEAR Jurisdiction CITY OF PORT TOWNSEND Permit No. BLD 10004 Project JEFFERSON HEALTHCARE Engineer Location JEFFERSON GENERAL HOSPITAL Architect Client JEFFERSON HEALTHCARE Contractor ANDERSON Field Data CYLINDER REPORT Reported Batch Data Concrete x Other Design Actual Weights Weights Supplier COTTON Plant No. Site Mix Mix No. - 40COM654 Cem. Ibs. = 610 Mix Air Unit F. Ash Ibs. - - Slump Temp. Temp. Wt. C. agg. Ibs. 1 PEA 155 Time Truck# Ticket # % Air (in.) (F) (F) (pcf) C. agg. Ibs. 2 0.75 1625 8:35 45 470 7 8 64 50 7 C. agg. Ibs. 3 - - Sand Ibs. - 1318 Water Ibs. - 28gal Placement Area Air Ent. (0z) - - Location SLAB, MRI TENANT IMPROVEMENT. SAMPLED AT Other (oz) | POLY 21.6 oz 4 OF 12.5 TOTAL YARDS PLACED; SOUTH, CENTER OF Other(oz) GLEN 23.9 oz 8" THICK SLAB FLOOR. Other (02) - - Other (oz) - - Water Added on Job (gals.) Field Test Methods Remarks PLACED BY BOOM PUMP; CONSOLIDATED BY X ASTM C143 ASTM C138 MECHANICAL VIBRATION. X ASTM C1064 ASTM C173 X ASTMC31 Other Inspector LOWELL DAVIS Laboratory Data Design Strength 4,000 @ 28 days Date Specimens Rec'd. 4/30/2010 Cyl. Test Field Max. Comp. Tested Break Laboratory Code Date Cure Age Dim. Area C.F. Load Str.(psi) Set# By Type] Test Methods P17717 5/6/2010 7 4x8 12.56 60430 4,810 ZL 3. |X ASTMC39 P17717 5/27/2010 28 4x8 12.56 79210 6,310 AC 3 ASTM C109 P17717 = =5/27/2010 28 4x8 12.56 78560 ~=6,250 AC 1 ASTM C617 P17717 5/27/2010 28 4X8 12.56 74230 = 5,910 AC 1 |X ASTM C1231 P17717 ASTM C780 P17717 Other P17717 P17717 Test Results Remafks FR 119581 X Conforming a Reviewed By p-“ Date Reviewed Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C-39 +/- 8% Form 03101 Revision 2 tttective Date 12/02/02 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 Krazan & Associates fe en 22K razan & ASSOCIATES, INC. ‘ if GEOTECHNICAL ENGINEERING ¢ ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING & INSPECTION May 28, 2010 KA Project No.: 106-10051 Building Permit No.: BLD10-004 Ms. Dana Michelson Jefferson Healthcare 834 Sheridan Avenue Port Townsend, WA 98368 RE: Jefferson Healthcare Tenant Improvement MRI Port Townsend, WA Dear Ms. Michelson: In accordance with your request and authorization, the following test data are presented on the following reports, which are enclosed: April 7, 2010 Cylinder Report No. 48982 — 28 Day Break April 8, 2010 Cylinder Report No. 49074 — 28 Day Break April 26, 2010 Cylinder Report No. 47332 — 28 Day Break May 18, 2010 Field Report No. 120331 May 19, 2010 Field Report No. 119771 May 21, 2010 Field Report No. 119595 Referenced concrete reports and compressive strength data will be mailed following 28-day tests, if applicable. If you have any questions, or if we can be of further assistance, please do not hesitate to contact our office. Respectfully submitted, fo~ Sk, Penn Seely, Laboratory Manager Peninsula Division PS: md Enclosures ce: City of Port Townsend — Fred Slota With Offices Serving The Western United States 1230 Finn Hill Rd NW Ste. A Poulsbo, Washington 98370 ¢ (360) 598-2126 Fax: (360) 598-2127 Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-10051 Cyl. Code P17618 PourDate 4/7/2010 Report No. 48982 Weather O'CAST Jurisdiction CITY OF PORT TOWNSEND Permit No. BLD 10-004 Project JEFFERSON HEALTHCARE Engineer Location PORT TOWNSEND Architect Client JEFFERSON HEALTHCARE Contractor ANDERSON Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier MUTUAL Plant No. Site Mix X Design Actual Initial Weights Weights Flow or Grout Air Max/Min Mix No. = - Slump Temp. Temp. Temp. Cem. Ibs. - - Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. 7 - 12:20 - = - FLUID 57 48 - C. agg. Ibs. 1 - - C. agg. Ibs. 2 = = Grout Box Used xX C. agg. Ibs. 3 - - Number of units used to form specimens 1 Sand Ibs. - - Water Ibs. 7 - Placement Area Air Ent. (oz) - - Location MRI WALL SECOND LIFT Other (02) - - MUTUAL MATERIALS COURSE GROUT Other (02) - - DESIGN MIX, 80LB BAG. Other (02) - - Other (0z) - - Water Added on Job (gals.) = Field Test Methods Remarks SITE MIXED; MECHANICALLY CONSOLIDATED TWICE, X ASTMC143 ASTM C138 PLACED BY BUCKET. X ASTM C1064 ASTM C173 xX ASTMC31 ASTM C780 OTHER Inspector BILL UGOLINI Laboratory Data Design Strength 2,000 @ 28 days Date Specimens Rec'd. 4/8/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb = Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type ASTM C109 P17618 4/14/2010 7 3.25 6.00 - 10.59 46235 4,370 ZL 2 |X ASTMC617 P17618 5/5/2010 28 3.32 6.00 - 11.02 58325 5,290 ZL. 3 ASTM C1019 P17618 5/5/2010 28 3:32 6.00 : 11.02 60280 5,470 ZL 3 Other P17618 H 3.32 6.00 - 11.02 59300 5,380 ZL 3 Test Results Remarks FR 119973 X Conforming Results Reviewed By we Date Reviewed Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Form 04103 Revision 0 Ettective Date 12/02/02 The information provided on this report is prepared for the exclusive use of the client. This report may not be reproduced in any tormal without! the wnitlen permission of the client and Krazan & Associates. ~ Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 4/8/2010 Project No. 106-100051 Cyl. Code P17619 Pour Date Weather PT. CLOUDY Jurisdiction CITY OF PT. TOWNSEND Project JEFFERSON HEALTH CARE Engineer Location PT. TOWNSEND Architect Client JEFFERSON HEALTH CARE Report No. 49074 Permit No. 2009-4 Contractor WINSLOW MASONRY Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. Site Mix X Design Actual Initial Weights Weights Flow or Grout Air Max/Min Mix No. DESIGN MIX Slump Temp. Temp. Temp. Cem. Ibs. 80 Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. - 11:10 - - == FLUID 54 60 7 C. agg. Ibs. 1 - C. agg. Ibs. 2 Grout Box Used Xx C. agg. Ibs. 3 - Number of units used to form specimens 1 Sand Ibs. - Water Ibs. 3gal Placement Area Air Ent. (0z) - Location CMU WALL MRI SUITE COURSE 12-15 INCLUDING Other (02) - BOND BEAM Other (oz) - Other (oz) - Other (oz) = Water Added on Job (gals.) 3 Field Test Methods Remarks GROUT PLACED VIA BUCKET AND BAG. X ASTM C143 ASTM C138 X ASTM C1064 ASTM C173 X ASTMC31 X ASTM C780 OTHER Inspector AARON CLYDE Laboratory Data Design Strength 3,000 @ 28 days Date Specimens Rec'd. 4/9/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb= Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type ASTM C109 P17619 4/15/2010 7 3.00 6.00 0.0 10.87 41220 3,790 1 AC 4 |X ASTMC617 P17619 5/6/2010 28 3.00 6.00 0.0 10.96 59090 5,390 1 ZL 1 ASTM C1019 P17619 5/6/2010 28 3.00 6.00 0.0 10.96 59865 5,460 1 ZL 3 Other P17619 H 3.00 6.00 0.0 10.96 59480 5,430 1 ZL 3 Test Results Remarks FR 117896 X Conforming Results Reviewed By we Date Reviewed Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% eines Effective Date 12/02/02 The information provided on this report is prepared tor the exclusive use of the client This report may not be reproduced in any formal without the written permission of the client and Krazan & Associates L Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-1 0051 Cyl. Code P17706 PourDate 4/26/2010 Report No. 47332 Weather O'CAST Jurisdiction CITY OF PORT TOWNSEND Permit No. BLD 10-004 Project JEFFERSON HEALTHCARE MRI Engineer Location JEFFERSON GENERAL HOSPITAL Architect Client JEFFERSON HEALTHCARE Contractor ANDERSON Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. - Site Mix X Design Actual Initial Weights Weights Flow or Grout Air Max/Min Mix No. - - Slump Temp. Temp. Temp. Cem. Ibs. - - Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. - - 1:00 = - - FLUID 70 67 - C. agg. Ibs. 1 - - C. agg. Ibs. 2 - 7 Grout Box Used - C. agg. Ibs. 3 - - Number of units used to form specimens 4 Sand Ibs. - - Water Ibs. = - Placement Area Air Ent. (0z) - - Location EAST WALL: DOORWAY INFILL (8" BLOCK) Other (oz) - - SAMPLED AT 8TH COURSE UP. Other (oz) - - REINFORCEMENT CONFORMS. Other (oz) - - Other (0z) = - Water Added on Job (gals.) - Field Test Methods Remarks PLACED BY BUCKET; CONSOLIDATED BY HAND. X ASTMC143 ASTM C138 X ASTM C1064 ASTM C173 xX ASTMC31 ASTM C780 OTHER Inspector LOWELL DAVIS Laboratory Data Design Strength 2,000 @ 28 days Date Specimens Rec'd. 4/27/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb-= Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set # By Type ASTM C109 P17706 5/3/2010 7 2.00 2.00 4.00 12320 3,080 ZL 1 ASTM C617 P17706 5/24/2010 28 2.00 2.00 4.00 17255 =4,310 Zi 1 |X ASTM C1019 P17706 5/24/2010 28 2.00 2.00 4.00 16760 4,190 ZL 1 Other P17706 H 2.00 2.00 4.00 17645 4,410 ZL 1 Test Results Remarks FR 119579 X Conforming Results Reviewed By pv/ Date Reviewed Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Form 04103 Revision 0 Ettective Date 12/02/02 The intormation provided on this report is prepared for the exclusive use of the client. This report may not be reproduced in any formal without the written permission of the chent and Krazan & Associates FIELD REPORTNO: 170331 42Krazan & Associates, Inc. GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION pate: “2- 18-1) 0 CONTRACTOR: JAAN decsonl PROJECT#:_1 0 b&- \ Coos } JURISDICTION: (a FL 1 ONS eid PROJECT “Je FE epsonl Healthcare PERMIT#: —— LOCATION: SVNecidenN Ave INSPECTOR: <) oe {Spa dyin KRAZAN PROJECT MANAGER: __~) wa. ‘10 WEATHER: 0 °C as %& TEMP: & “2. Onl Ste Mer Cenyes* For Specia\ =TaAlsyection OF EX pansion Dreher Yoo Les. Conrtracker ipstatled lo 3X and O-SS/AxXN AX _ Syyppore Steucwre ar PTDVS Yer dens 6.8 ot SU. Contractor Cleanted holes anid ‘installed CrxpaNnsion anchor Wolts Wihh @ widiww S" of eya\o2d ment sper \on) arid Vacquess rs SPeciF\ cations. Equipment/Asset Number(s): To the best of mi owledge the songs) WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Représéntative: Ne » \wePoaureln This report indicates our inspector's observation and testing results based on the site condition and contractor's sinh is information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by ers on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 EFFECTIVE: 4/22/2009 DAILY FIELD REPORT 2009.doc 423Kr . FIELD REPORT NO: 119771 [= aZan 3 Associates, Inc. GEOTECHNICAL ENGINEERING a ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION pate: Wa/PA-L O CONTRACTOR: AAW BE5E84) CAS >— PROJECT #:_ OG ~ 2 7004 | JURISDICTION: _ 42.7% PROJECT: \7/2FF#25 0.) HEALTHCARE PERMIT# ZGLD so-—lOpZ LOCATION: __ fz INSPECTOR: WALZ. AWG pkrro/ . KRAZAN PROJECT MANAGER: VLA) WEATHER: Sv.) TEMP: .570 S& ON STE PCR WELD NS PECTINN FRR FLL BT LUPL ES On 8TH WPPORT SC TUCE- UWekné PER beérazg”~ CEP GF S-4_ BY CPL BAMPAD SBY THEY kp OGEY, Cow F0ens TO NOE Pr fod WAZOO _|WHADER SHARE HSGCCAE, Equipment/Asset Number(s): To the best of my knowledge, the abo és / WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Tenner Af ~ Pi 4 Uke D lor This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to fin: bmittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 EFFECTIVE: 4/22/2009 DAILY FIELD REPORT 2009.doc Ps sez FIELD REPORT NO: 179595 43K raZan « Associates, inc. i GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: 05 /a//a0/0 CONTRACTOR:__A NDERSov PROJECT #:_ /OG-~/005/ JURISDICTION: _C 7g Qe Shar Tame sab PROJECT: PERMIT #: LOCATION:_Jéseez @ San Gewe3nne Mos rde INSPECTOR: Low Fz¢ec D#4Oo7s KRAZAN PROJECT MANAGER: 5B WEATHER: preg CLoueoy TEMP: 50° ARAZAN LUSPECTOR OWN S/7TE FoR ZRopRieTars AN E-#oeR TNSPECTION. ZoCAarrvow OF Work, ON THE Rack AS pER RFL cal 39 R2, TRANS For mMeER PETUHL4CS FSoRnezD A ZINSIDE cOokNER , A EF Se PORT FRErABEO STEEL THAT ws WELDED ANO GacyinIZ£E 2 AQPROsImMATELG £1 eur F xe acy Dipecriow , FRaN THE FHSIDE <ORWVER, Hells w ERE Derctey {2"O.C . we Te 4 2a" OR1é4¢é 3,7 TNTS THE 7OP OF ZFHE 40 EE Si ssones uel 4 Lv Golit Dintctiew Ss Aabesrunaraiy 2! Fan 16 Keres Talal. 7 THE NerIt, SeuTY Rupwing Waae oF 7 Poles 4» 25 Hellou Plesavas, “Sc REEN S “e wERE Usep, 6" En BeEODmMEKT OF %z 422 T7THREAD ROO THE £457, WEST Run pin € WOO oe 8 HOelE GS, ENCou AW TERED 5 Seed Sa/210 | 5g _Cftics wwene 28 wees Anetor Bodre wERE USED ‘ x LAE LHR EE etes 7M THE 1 RNEL OFTHE FAST WEST Lace. ur ERE Hotcom 9 iv 9 or Z Z Le; eas —e Holes tue ERE 2B ANEO bel 7 VAC ele, Coin RESED AI, AN O AVE IVEY Rouen GRUSH A 5 PER Sle 2504 BPX MAN e&AcTHRES Tv STRUCT 0s Slin 20h SET Efoxg, 107” £7? 3W 53 WY, wy IA Expbkelinn DATE ox o¢/os/11 intet S KH SED ,AS5 PER TNSTRECTION WY OF mM4anagmes RE FoR Hoszcow LAB ONRY Wht Equipment/Asset Number(s): To the best of my knowledge, the abov WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: aa So el aay This report indicateslour inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States . Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 EFFECTIVE: 4/22/2009 DAILY FIELD REPORT 2009.doc Ka = 4@Krazan & ASSOCIATES, INC. GEOTECHNICAL ENGINEERING # ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING & INSPECTION May 12, 2010 KA Project No.: 106-10051 Building Permit No.: BLD10-004 Ms. Dana Michelson Jefferson Healthcare 834 Sheridan Avenue Port Townsend, WA 98368 RE: Jefferson Healthcare Tenant Improvement MRI Port Townsend, WA Dear Ms. Michelson: In accordance with your request and authorization, the following test data are presented on the following reports, which are enclosed: April 6, 2010 Cylinder Report No. 49089 — 28 Day Break Cylinder Report No. 49090 — 28 Day Break Cylinder Report No. 49091 - 28 Day Break April 26, 2010 Field Report No. 119579 Cylinder Report No. 47332 - 7 Day Break April 28, 2010 Field Report No. 119580 April 29, 2010 Field Report No. 119581 (w/attachments) Cylinder Report No. 35345 — 7 Day Break May 5, 2010 Field Report No. 119585 Referenced concrete reports and compressive strength data will be mailed following 28-day tests, if applicable. If you have any questions, or if we can be of further assistance, please do not hesitate to contact our office. Respectfully submitted, fo St Penn Seely, Laboratory Manager Peninsula Division M AY 13 2010 PS: md i Enclosures CITY OF i sama cc: City of Port Townsend — Fred Slota With Offices Serving The Western United States 1230 Finn Hill Rd NW Ste. A ¢ Poulsbo, Washington 98370 ¢ (360) 598-2126 ¢ Fax: (360) 598-2127 Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-100051 Cyl.Code P17619 PourDate 4/6/2010 Report No. 49089 Weather PT. CLOUDY Jurisdiction CITY OF PT. TOWNSEND Permit No. 2009-4 Project JEFFERSON HEALTH CARE Location PT. TOWNSEND Client JEFFERSON HEALTH CARE Engineer Architect Contractor WINSLOW MASONRY Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. Site Mix X Design Actual Initial Weights Weights Flow or Grout Air Max/Min MixNo. DESIGN MIX Slump Temp. Temp. Temp. Cem. Ibs. 200 Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. - 12:57 - - -- FLUID 63 61 - C. agg. Ibs. 1 - C. agg. Ibs. 2 - Grout Box Used YES C. agg. Ibs. 3 - Number of units used to form specimens 1 Sand Ibs. - Water Ibs. 6gal Placement Area Air Ent. (oz) - Location CMU WALL MRI SUITE 0-32" FROM SLAB Other (oz) - Other (oz) - Other (0z) - Other (0z) - Water Added on Job (gals.) Field Test Methods Remarks MIXED ON SITE PER MFG SPECS X ASTMC143 ASTM C138 X ASTM C1064 ASTM C173 X ASTMC31 X ASTM C780 OTHER Inspector KAMERON BINNS Laboratory Data Design Strength 2,000 @ 28 days Date Specimens Rec'd. 4/7/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb = Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type ASTM C109 P17619 4/13/2010 7 3.00 6.00 0.0 10.82 45435 4,200 | ZL 1 |X ASTM C617 P17619 5/4/2010 28 3.00 6.00 0.0 10.69 55500 5,190 1 ZL 1 ASTM C1019 P17619 5/4/2010 28 3.00 6.00 0.0 10.69 57010 5,330 4 ZL 3 Other P17619 H 3.00 6.00 0.0 10.69 56255 5,260 4 ZL 3 Test Results Remarks FR # 119424 X Conforming Results Reviewed By ~~ Date Reviewed Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Form 04103 Revision 0 Effective Date 12/02/02 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 Krazan & Associates. Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-10051 Cyl.Code P17730 PourDate 4/6/2010 Report No. 49090 Weather INTERIOR Jurisdiction CITY OF PORT TOWNSEND Permit No. BLD 10-004 Project JEFFERSON HEALTH CARE Engineer Location PORT TOWNSEND Architect Client JEFFERSON HEALTH CARE Contractor ANDERSON MASONRY PRISM REPORT Reported Batch Data Types Preconstruction Prisms Construction X Grout Supplier DESIGN MIX Solid Unit Prism Hollow Unit ; Plant No Site Mix X Hollow Unit Prism Grouted Hollow Unit X Time 1:10 Grouted Hollow Unit Prism Grouted Mulit-Wythe Prism Truck No. = Ticket No. = General Information Slump (in) 11" Number of Bed Joints 1 Mortar Supplier Site Mix X Mix Temp (F) 63 Number of Masonry Units Used 2 Mortar Type Air Temp (F) 61 Date Constructed Masonry Unit Supplier Design Weight Max/Min Temperture (1st 48 hrs) Masonry Unit Dimension 8X16 Mix No. PRO GRADE Cem. Ibs. - 200 Placement Area Inspector KAMERON BINNS F. Ash Ibs. - - Location CMU WALL @ MRI ROOM: 0-32" LIFT FROM SLAB C. Agg. Ibs. - - Sand lbs. = - Water Ibs. = 6 gal Admix. (02) - = Remarks MIXED ON SITE PER MFG SPECS Water Added on Job (gals.) - Compression Testing Information Field Test Methods Diameter of Spherical Seat 9 Compression Machine X X ASTMC143 ASTM C173 Upper Bearing Plate Thickness 2 Calibration Date 9/9/2009 X ASTM C1064 ASTM C138 Lower Bearing Plate Thickness 1 xX ASTMC31 Other Laboratory Data Design Strength 1,500 @ 28 days Date Specimens Rec'd. 4/7/2010 Cyl. Test Width Height Length Net Max. Comp. HIT Corr. Break Code Date Age (in) (in) (in) Area Load Str.(psi) Ratio C.F. (psi) Type P17730 5/4/2010 28 8 16 8 58.29 204650 3510 3510 3 P17730 5/4/2010 28 8 16 8 58.29 191770 3280 3280 3 P17730 5/4/2010 28 8 16 8 58.29 219860 3770 3770 3 P17730 P17730 Sample 1 Sample 2 Sample 3 Sample 4 Sample 5 Lab Test Method 1: ASTM C1314 X 2: ASTM C109 X 3: ASTMC617 X 4: Other X X Conforming Results Reviewed By pe Date Reviewed Non-Conforming Types 1: Conical 2: Cone & Split 3: Cone & Shear 4: Tension 5: Semi Conical 6: Shear 7: Face Shell Seperation Measurement Uncertainties: Form 04102 Revision 0 Effective Date 12/02/02 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 Krazan & Associates. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Cyl.Code P17630 PourDate 4/6/2010 Report No. 49091 Jurisdiction CITY OF PT. TOWNSEND Permit No. BLD 10-004 Krazan & Associates, Inc. Project No. 106-100051 Weather PT. CLOUDY Project JEFFERSON HEALTH CARE Engineer Location PT. TOWNSEND Architect Client JEFFERSON HEALTH CARE Contractor ANDERSON Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. Site Mix X Design Actual Initial Weights Weights Flow or Grout Air Max/Min MixNo. DESIGN MIX Slump Temp. Temp. Temp. Cem. Ibs. 160 Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. - 11:25 - - -- FLUID 62 62 - C. agg. Ibs. 4 - C. agg. Ibs. 2 - Grout Box Used C. agg. Ibs. 3 - Number of units used to form specimens Sand Ibs. - Water Ibs. 6gal Placement Area Air Ent. (0z) - Location CMU WALL MRI SUITE 0-24" FROM SLAB Other (oz) - Other (oz) - Other (0z) - Other (0z) - Water Added on Job (gals.) Field Test Methods Remarks MIXED ON SITE PER MFG SPECS X ASTMC143 ASTM C138 X ASTM C1064 ASTM C173 xX ASTMC31 X ASTM C780 OTHER Inspector KAMERON BINNS Laboratory Data Design Strength 1,800 @ 28 days Date Specimens Rec'd. 4/7/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb = Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type X ASTM C109 P17630 4/13/2010 7 2.00 4.00 0.0 3.14 6660 2,120 4 ZL 1 |X ASTM C617 P17630 5/4/2010 28 =2.00 4.00 0.0 3.14 8595 2,740 1 ZL 4 ASTM C1019 P17630 5/4/2010 28 2.00 4.00 0.0 3.14 7870 2,510 4 ZL 4 Other P17630 H 2.00 4.00 0.0 3.14 7230 2,620 1 ZL 4 Test Results Remarks FR # 119424 X Conforming Results Reviewed By \c~ i Date Reviewed Non-Conforming Codes for Break Types: 1, Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Form 04103 Revision 0 Effective Date 12/02/02 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 Krazan & Associates. FIELD REPORTNO: 1719579 @2ZKrazan & Associates, Inc. * GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: __ @ of 2 ELADsIO CONTRACTOR: _AvOFeLSON PROJECT #:_ _ JOG - oor JURISDICTION: _ Bp Sey COL AT PROJECT: 2 PERMIT#: 24D -so-coy LOCATION: ENERBAL INSPECTOR: AgweEzZ£24 DOS KRAZAN PROJECT MANAGER: TB G WEATHER: zwzrees02 TEMP: gr? kesz2zen INSpecToe on SITE Fo Fpaxy Ancor ZASPECTION AZ, Stag w , >= és Contuctow wi REL A227 DATED 4/2P/2OlO«z Tis Clocsrion ON 2 2 Plume ie Tabet) 20 TE take 61DEOE Fi = NT a SZ2E CY ELDER REQ2RT FY 23AB2 FOR FEST Were, ON£E SETOF ¢- 2% 2“ —SaeG we ERE 2Aaol, Equipment/Asset Number(s): To the best of my knowledge, the abo WAS) WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: — This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our~ inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc EFFECTIVE: 4/22/2009 Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-10051 Cyl.Code P17706 PourDate 4/26/2010 Report No. 47332 Weather O'CAST Jurisdiction CITY OF PORT TOWNSEND Permit No. BLD 10-004 Project JEFFERSON HEALTHCARE MRI Engineer Location JEFFERSON GENERAL HOSPITAL Architect Client JEFFERSON HEALTHCARE Contractor ANDERSON Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. - Site Mix X Design Actual Initial Weights Weights Flow or Grout Air Max/Min Mix No. = - Slump Temp. Temp. Temp. Cem. Ibs. - - Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. - - 1:00 - * - FLUID 70 67 - C. agg. Ibs. 4 - - C. agg. Ibs. 2 # = Grout Box Used - C. agg. Ibs. 3 = - Number of units used to form specimens 4 Sand Ibs. - - Water Ibs. - - Placement Area Air Ent. (oz) - - Location EAST WALL: DOORWAY INFILL (8" BLOCK) Other (oz) - - SAMPLED AT 8TH COURSE UP. Other (oz) - os REINFORCEMENT CONFORMS. Other (oz) - - Other (0z) - - Water Added on Job (gals.) d Field Test Methods Remarks PLACED BY BUCKET; CONSOLIDATED BY HAND. X ASTMC143 ASTM C138 X ASTM C1064 ASTM C173 X ASTMC31 ASTM C780 OTHER Inspector LOWELL DAVIS Laboratory Data Design Strength 2,000 @ 28 days Date Specimens Rec'd. 4/27/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb = Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type ASTM C109 P17706 5/3/2010 7 2.00 2.00 4.00 12320 3,080 ZL 1 ASTM C617 P17706 5/24/2010 28 X ASTM C1019 P17706 5/24/2010 28 Other P17706 H Test Results Remarks FR 119579 Conforming Results Reviewed By Jey | Date Reviewed $-3-y, Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Form 04103 Revision 0 Effective Date 12/02/02 The information provided on this report is prepared for the exclusive use of the client. This report may not be reproduced in any format without the written permission of the client and Krazan & Associates. FIELD REPORTNO: 1795890 @2Krazan & Associates, Inc. GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE:__ © ¥/28/ 2e/0 CONTRACTOR: _@v0e2s0r PROJECT #:_/0G-/OOS57 JURISDICTION: <4 74 o£ Moat To PROJECT:__ teereceson Meserveene Tenant PERMIT#:_ B40 - 0 ee LOCATION: we eee eso Geveen Hosoilsl IDeT Souwnsieno INSPECTOR: ___4 mar eee 4urhs KRAZAN PROJECT MANAGER: baD yf WEATHER: Zws DE TEMP: 45° _KRA2ZAN ZNVSPECTOe OW SI7E FACR SPEC 4e “TnspiCrion Of REIN roucEemenr STEELS. w)J7H Se" Rite [o" Oc. Bact Wise on BDOGES LY CESEROF 6" ELAG_ __ hs in cénr oF tae Aeeice, deca i Osta cane de EAs REAL ED nl doe} To EXS($STIHG FROCES OF SA C47 CovcREeTe. 45 DRY OM SHEET SR, ee ned an E tmauah, aangan in uted, deta AP A¢“oec, AT Equipment/Asset Number(s): To the best of my knowledge, the above / WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Represéntative: Technician: a pe This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 EFFECTIVE: 4/22/2009 DAILY FIELD REPORT 2009.doc FIELD REPORTNO: 1719587 43kKrazan & Associates, Inc. GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE:__ 6 4¥/a?/ 20/0 CONTRACTOR: _.SWDER sow PROJECT #:_ /o G=—/0O057/ JURISDICTION: _c/7% ae FaRT Te we SEND PROJECT: _Weekzeson Hester eane FenAanr PERMIT#:. 429- promos LOCATION: _Deé4ekson wevensc faspirAe . INSPECTOR: sow 44 Oss S$ KRAZAN PROJECT MANAGER: TB ¢ WEATHER: CLEAR TEMP: 4205 __keAzen INSCECTER OW S/TE FOR SefcI2e TNseictrian CF CONCRETE Fhackmes7 27. SZAB F4020R FoR JOA ZF. : sw GARD Oe Ce7eow RED H—712x Serr HOvERETE , 2772 X YOCOM CS.S: nutZes _AAACED Bag Boom Pum~e, Tides A Raat o2EWiN€. B26 CmNCRETE late S e 18 - SS . TLEMPERATH RE @ ONE SET OF &— KF" mo mye RESSiaN TEST SA MOLES LMERE CAST. _THE ARMATRRE ELENIUM 1500 wAS MeEASuRED INO ADDED Ta Fact 404D DQM SITE, ZO QeTimiZ& Stwwmees SFE Sy deve Rr ReEpeRT BE BYE FOR TEST DATA. Equipment/Asset Number(s): To the best of my knowledge, the abov€WASY WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others onsite. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 EFFECTIVE: 4/22/2009 DAILY FIELD REPORT 2009.doc Andersen Construction Company 228 South Mead Street Seattle WA 98108 ANDERSEN TRANSMITTAL No 10-SP003-0037 PROJECT: Jefferson Healthcare Tenant Improvement TO: Coates Design, Inc 710 John Nelson Lane Bainbridge:Isiand WA 98110 ATTN: Bob:Miller:-Rhees WE ARE SENDING: SUBMITTED FOR: DATE: 04/26/2010 RE: 03300-Conerete Mix Design JOB: 10-SPR003 ACTION TAKEN: Shop Drawings /. Approval Approved as Submitted Letler _ Your Use _ Approved as Noted Prints As Requested Returried-After Loan | Change Order Review and Comment. ~ Resubmit ’ Plans Submit Samples p ~.. Returned Specifications ‘Attached — Sepatate Cover Returned for Corrections VY. Other: Product Data Due Date: Other: Line Item Package — Code Rev. Qty Date Description Status — 1 Submittal 03300-0{ 03300 04/26/2010. Concrete Mix Design Open TINO EXCEPTION TAKE! : é as Ri REVISE. ee NOTED REVIEWED FOR GEN nid CONTRACT ALL QUANTI DNSIBLE FOR COMPLIAN StcAND.COMPLETE ANDERSEN'CONSTRUCTON CO,, INC BY: ~AHME #;; ATE: <7 9), ae ACCO JOB #:_ /O~SROS SUBMITTAL #: 03320) -oO / REMARKS: ce: Signed: Jamie Puracal Mix Design Report COTTON REDIMIX P.O. Box 179 121 PROMWELL RD. PORT HADLOCK, WA 98339 USA 800-732-5683 seeMIX il Mix Report 4000 psi6.5 sack-6.5 sack com [1] Strerigth Compressive: 4000 psi (04/23/2010 Compressive Strength : [4000 psi at 28 Days Source of Concrete. Aggregate size : Construction type : Air: 0:0 0.0% Placement : Water/Gement ratio: | 0.450 Unit Weight; 144.97 — pef Slump : 0.00 0.00 in Design Date. 07/11/2008 — Constituents : Quantity Density Volume CEM02 - ABC Type I/ll Cement (ASH GROVE CEMENT) 611 Ib} 3.150) 3.108 WATO1 = City Water (City Water supply) 275 tb} 1.000) 4.407 CA1 - ASTM.G-33. #57 Stone (PLANT 1) 1629.lb, 2.690; 9.705 FA1 - ASTM C-33 Concrete Sand (PLANT 1) 1246 lb} 2.660! 7.507 |PEA - Pea gravel (PLANT 1) 151 Ib] 2:700) 0.896 WR = POLYHEED 997 (BASF ADMIXTURES INC) 21.00 floz (US)/yd4) 1.100; 0.022 Air 6.0 %: 1.350 Total : 3914) 26.995 Remarks : If additional slump is required at job site we can have BASF Master Builders Glenium 7500 available on site. REVIEWED AND NQTED FOR DESIGN INTENT ONLY DIMENSIONS & Qi TIES NOT GUARANTE: Reported by DENNIS MORGAN Approval by : a oe s STRUCTURE ONL' im Date: 02/22/2010 Date : iy NOEXCERTINS TIEN Yt” ; im 04/23/2010 COMMENTSATTACKED ©] REVISE & RESUBMIT im] By_SM pare 4/26/2010 COUGHLIN PORTER LUNDEEN, INC. Consulting Engineers Seattle, Washington 98101 4000 psi 6.5 sack-6 5 sack com [1] 4000 psi Mix Design Report Concrete Mixture Submittal Design summary Water Design % Reduction: 0,0 Manual Entry Method DRUW / FA: 0.00 pcf FA Density: 0.00 pef Quantity: 275 Ib Cement Design Number of tests: 0 Manual Entry Method Cement Efficiency: 0.00 psi/lb Standard Deviation: 0 Prob. low test. 1 in: 100 Water/Cement Ratio: 0.450 Ibs/Ib Quantity. 611 Ib Mineral Additive Design Material name: Replacement Method Ratio Quantity % , Coarse Aggregate Design Work Adj. Factor 36,2 Manual Entry Method Percent Mortar: 56.4 Total Fine Modulus: 514 CA Fine-Madulus: 6.89 Coarse DRUW 98.00 Quantity 1629 Ib Total Agg. %: 98.00 M.S.F.: 25.300 Fine Aggregate Design Volume: 27.000 yd* Produce Specific Volume Fineness Modulus: 3.12 Quantity: 1397 Ib Admixture Design Material name Quantity Inc. in WIC ratio Inc. in volume WR - POLYHEED 997 (BASF 21.00 floz No Yes 04/23/2010 f= BASF The Chemical Company Description GLENIUM* 7500 full-range water-reducing admixture 1s. based on the next generation of polycarboxylate technology found in ail of the GLENIUM 7000 series products. This technology combines slale-of- the-art molecular engineering with a precise understanding of regionat cements to provide specific and exceptional value lo:all phases of the concrele construcon process. GLENIUM 7500 admixture is very effective in producing concrele mixtures with different levels of workability including applications that require self-consolidating concrete (SCC). The use of GLENIUM 7500 admixture results in fasler setting characteristics as well'as improved early age compressive strength. GLENIUM 7500. admixture meets. ASTM C 494/C 494M compliance requirements for Type-A, water-reducing, and Type F, high-range water- reducing, admixtures. Applications Recommended for use in Concrete with varying water reduction requirements (65-40%) Concrete. where control of workability and setting time is critical Concrete where high flowability, increased stability, high early. and ultimate strengths, and improved durability are needed Production of Rheodynamic” Self- Consolidating Concrete (SCC) mixtures 4x4™ Concrete for fast- track construction Pervious Concrete mixtures uct Data “Miane Concrele ; Conerste Mass Concrete Masonry Grouting i o330 00 7 ‘| 034000. 02 70-00 03.06 18. GLENIUM® 7500 Full-Range Water-Reducing Admixture Features Dosage flexibility for normal, mid-range-and high-range applications Excellent early strength developmen! Controls.selting characteristics Optimizes slump retention/setting relationship Consistent air entrainment Benefits Faster turnover of forms due to accelerated early strength development Reduces finishing labor costs due lo optimized sel times Use in fast track construction Minimizes the need for slump adjustments at the jobsite Less fobsite QC support required Fewer rejected loads Optimizes concrete mixture cosls Performance Characteristics Concrete produced with GLENIUM 7500 admixture achieves significantly higher early age strength than first generation polycarboxylate high-range waler-reducing admixtures. GLENIUM 7500:admixture also strikes the perfect balance between workability retention.and.setling charactenstics in order to provide-efticiency in Placing and fimshing concrete. The dosage flexibility of GLENIUM 7500 allows it to be used as a normal, mid-range, and high-range water reducer, Guidelines for Use Dosage: GLENIUM 7500 admixture has a recommended dosage range of 2-15 fl oz/ewt (130-975 mL/100 kg) of cementitious materials. For most mid-to high-range applications, dosages in: the range of 5-8 fl oz/cwt (325-520 mL/100 kg) will provide excellent periormance. For high performance and Rheodynamic Self- Consolidating Concrete mixtures, dosages of up lo 12 fl.oz/cwt (780 mL/100 kg) of cementitious materials can be utilized. Because of variations in concrete materials, jobsite congitions and/or applications, dosages outside of the recommended range may be required. In such cases, contact your local BASF Construction Chemicals representative. Mixing: GLENIUM 7500 admixture can be added with the.initial batch water or as a delayed addilion. However, optimum water reduction is generally obtained witha delayed addition, Master Builders i) BASF Corstrucuon Chem.cals, 2009 = Priited in USA Product Data: GLENIUM® 7500 Product Notes Corrosivity - Non-Chioride, Non-Corrosive: GLENIUM 7600 admixture will neither initiate nor promote corrosion of reinforcing steel embedded in concrete, prestressing steel or of.galvanized steel floor and roof systems. Neither calcium chloride nor other chloride-based ingredients are used in the manufacture of GLENIUM 7600 admixture. Compatibility: GLENIUM 7500 admixture is compatible with most admixtures used in the production’of quality concrete, includirig normal, mid-ratige and-high-range water-reducing admixtures, air-entrainers, accelerators, relarders, extended set contro! admixtures, corrosion inhibitors, and shrinkage reducers, . Do not use GLENIUM 7500 admixture with admixtures containing beta-naphthalene sulfonate. Erratic behaviors in slump,.workability retention and pumpability may be experienced. Storage and Handling Storage Temperature: GLENIUM 7500 admixture must be stored at temperatures-above 40 °F (5 °C), jf GLENIUM 7500 admixture freezes, thaw and reconstitute by mechanical agitation, Shelf Life: GLENIUM 7500. admixture has. a minimum shelf life of 9 months. Dépending on storage conditions, the shelflife may be greater than stated. Please contact your local sales representative regarding suitability for use and dosage recommendations if the shelf life of GLENIUM 7500 admixture has been exceeded. Packaging GLENIUM 7500 admixture is.sUpplied in 65 gal (208 L) drums, 275 gal (1040 L) totes and by bulk delivery. Related Documents Material Safety Data Sheets: GLENIUM 7500 admixture. BASF Construction Chemicals Adrnixture. Systems www.masterbuilders.com ‘ United States 23709 Cragrin Boulevard, Cleveland, Ong 44122-9544 Tel; 800 628-9900 Fax 716 839-8821 Carada 1806 Clark Bovlevary, Branpion, Oniary LOT 4M7 Tel BOO 387-5862 Fax. 905 792-065" 4 & Corstruction Research & Techna ugy GMBH 12/098 LIT # 2000025 Additional information For additional information on GLENIUM 7500 admixture or on its. use in:develaping concrete mixtures with special performance characteristics, contact your BASF Construction Chemicals representative. The Admixture. Systems. business of BASF Consiniction Chemicals is a.leading provider of innovative admixtures for specialty concrete used in the ready-mix, precast, manufactured concrete products, underground construction and paving markets throughout the North-American region. The: Company's respected Master Builders brand products. are used lo improve the placing, pumping, finishing, appearance and performance characteristics of concrete. LIMITED: WAGRANTY NOTICE. Wwe wari! our products to.be of good quatty and wil replace or. avour discralion, dfunc Ihe five price Of any ts proved defactwe Satistactory easily depdnd not only Upon qualty. prodycts; bul also upanstrany actore beyend our.conirot Thatetute except for such replacement or relund, BASF MAKES NO WARRANTY OR GUARANTEE, EXPALSS.QR IMPLIED. INCLUDING WARRANTIES OF TITNESS FORA PARTICULAR Pun OSE OR MERCHANTABILITY, RESPECTING USF PRODUCTS. aria BASF shal? have nu other hokulity val réspect reac Any clams regu Ging procul Guléct Muist of fecigdedcs ir wating wittn.ong (1) year from the date cf User shail ofthe products -lor Wie wlenaed use and atsumeai nsks. und: “talitity 1 counechon therewith. Any authorized change in the ponte recommendatuls cuhcerniy Ihe use of our products s1ust-beur the'siqnatury af ire BASF “Technical Manager This information ‘and ail further tecrucel advice are based un BASF's present xnowiedge art eaperience. tlowever, BASF: assumes ng babdiy for providing suct information and advice incivding Ine'extenit ty which suc nformalion ypu advice May relate ta existing Inird. oarly Atelleclual ploperty eghts. especiaily pater nghts BAST SUALL NOT GE RESPONSIELE FOR CONSEQUENTIAL, INDRECT: OR INCIDENTAL DAMAGES ('NCLUDING LOSS: OF PROFIFSI OF ANY #UNO: ey fascives Ihe night to make any changes.accord:ny to or et uh BORE For Professionat use only. Notfor solo to or use by the general public. Master Builders Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-10051 Weather CLEAR Cyl. Code P17717 Pour Date Jurisdiction CITY OF PORT TOWNSEND 4/29/2010 Report No. 35345 Permit No. BLD 10004 Project JEFFERSON HEALTHCARE Engineer Location JEFFERSON GENERAL HOSPITAL Architect Client JEFFERSON HEALTHCARE Contractor ANDERSON Field Data CYLINDER REPORT Reported Batch Data Concrete Xx Other Design Actual Weights Weights Supplier COTTON Plant No. Site Mix Mix No. - 40COM655 Cem. Ibs. - 610 Mix Air Unit F. Ash lbs. - - Slump Temp. Temp. Wt. C. agg. Ibs. 1 PEA 155 Time Truck# Ticket # % Air (in.) (F) (F) (pcf) C. agg. Ibs. 2 0.75 1625 8:35 45 470 - 8 64 50 - C. agg. Ibs. 3 - - Sand lbs. - 1318 Water Ibs. - 28gal Placement Area Air Ent. (oz) - - Location SLAB, MRI TENANT IMPROVEMENT. SAMPLED AT Other (0z) POLY 21.6 oz 4 OF 12.5 TOTAL YARDS PLACED; SOUTH, CENTER OF Other (0z) GLEN 23.9 0z 8" THICK SLAB FLOOR. Other (oz) - - Other (0z) - = Water Added on Job (gals.) Field Test Methods Remarks PLACED BY BOOM PUMP; CONSOLIDATED BY X ASTMC143 ASTM C138 MECHANICAL VIBRATION. X ASTM C1064 ASTM C173 X ASTMC31 Other LOWELL DAVIS Inspector Laboratory Data Design Strength 4,000 @ 28 days Date Specimens Rec'd. 4/30/2010 Tested Break By Type ZL 3 Laboratory Test Methods X ASTM C39 ASTM C109 ASTM C617 ASTM C1231 ASTM C780 Other Test Results Conforming Non-Conforming Cyl. Test Field Max. Comp. Code Date Cure Age Dim. Area C.F. Load Str.(psi) Set# P17717 5/6/2010 7 4x8 12.56 60430 4,810 P17717 5/27/2010 28 4x8 P17717 5/27/2010 28 4X8 P17717 5/27/2010 28 4X8 P17717 P17717 P17717 P17717 Remarks FR 119581 Results Reviewed By pe Q Date Reviewed $ -- y Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear Measurement Uncertainties: ASTM C-39 +/- 8% Form 03101 Revision 2 Effective Date 12/02/02 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 Krazan & Associates. 5: Columnar (Split) <5 FIELD REPORT NO: 119585 @Krazan & Associates, Inc. LLGIS GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: os/loZz/2 O72 CONTRACTOR:__ AW DER sex PROJECT #:_40@G -sans / JURISDICTION: _ <1 7% BF SORT Toe sen pp PROJECT: JD E¢*Fe0sor Mm RL LmPeRovioame7 PERMIT#: BLN LOCATION: nw Za INSPECTOR: Low sce es 5 KRAZAN PROJECT MANAGER: on Ld WEATHER: _-4—_9-6% syezne _TEMP:Z°7° Hola. A, en, Z $0 - Mw , 244 LINTE TAA wAS Cua7 zw Fo 2xse7uy C= 227 S ODMR nc BBL, oT WIEST weer = 13; z Zz 2 oF /” fozes AM ED 4112 8 aR , M6 REA, : _u1TW wer pg 2¢ 4 2 ELOxy fiery wWAs UslD As Seknes eo Sees Deges To F126 GALS OF THE S4w <4 75 WHERE LinT ee ReESTEO (‘a we an £2ch/ S1DE OF De2R anZo, ALSO Exeausian Aah Disehstias AWE te Okt eee TO Rat Qs DRAWN OW SHYZET S-Y, Dena Hz FB" wre Ex pension GlLTS , TH oe , 7, ss oy, p = = BEL. Zi. 14.5 Dita, FoR Orrtch mel ON LACH SIDE OF NEA. Cree te 6 Cm __ Equipment/Asset Number(s): To the best of my knowledge, the abov(WASY WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: ibe tll ESD sassy This report indicates our inspector's observation and testing results based on the-site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc EFFECTIVE: 4/22/2009 43K raZan «associates, inc. GEOTECHNICAL ENGINEERING ¢ ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING & INSPECTION April 28, 2010 KA Project No.: 106-10051 Building Permit No.: BLD10-004 Ms. Dana Michelson Jefferson Healthcare 834 Sheridan Avenue Port Townsend, WA 98368 RE: — Jefferson Healthcare Tenant Improvement MRI Port Townsend, WA Dear Ms. Michelson: In accordance with your request and authorization, the following test data are presented on the following reports, which are enclosed: April 6, 2010 Cylinder Report No. 49091 — 7 Day Break Cylinder Report No. 49089 — 7 Day Break April 7, 2010 Field Report No. 119973 Cylinder Report No. 48982 — 7 Day Break April 8, 2010 Field Report No. 117896 Cylinder Report No. 49074 — 7 Day Break April 23, 2010 Field Report No. 117733 Referenced concrete reports and compressive strength data will be mailed following 28-day tests, if applicable. If you have any questions, or if we can be of further assistance, please do not hesitate to contact our office. Respectfully submitted, bo~ 5.2 Penn Seely, Laboratory Manager Peninsula Division PS: md Enclosures cc: City of Port Townsend — Fred Slota With Offices Serving The Western United States 1230 Finn Hill Rd NW Ste. A ¢ Poulsbo, Washington 98370 ¢ (360) 598-2126 ¢ Fax: (360) 598-2127 Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-100051 Weather PT. CLOUDY Cyl. Code P17630 Pour Date Jurisdiction CITY OF PT. TOWNSEND 4/6/2010 Report No. 49091 Permit No. BLD 10-004 Project JEFFERSON HEALTH CARE Engineer Location PT. TOWNSEND Architect Client JEFFERSON HEALTH CARE Contractor ANDERSON Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. Site Mix X Design Actual Initial Weights Weights Flow or Grout Air Max/Min Mix No. DESIGN MIX Slump Temp. Temp. Temp. Cem. Ibs. 160 Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. “ 11:25 - = —— FLUID 62 62 = C. agg. Ibs. 1 - C. agg. Ibs. 2 - Grout Box Used C. agg. Ibs. 3 - Number of units used to form specimens Sand Ibs. - Water Ibs. 6gal Placement Area Air Ent. (oz) - Location CMU WALL MRI SUITE 0-24" FROM SLAB Other (02) - Other (oz) - Other (oz) - Other (0z) - Water Added on Job (gals.) Field Test Methods Remarks MIXED ON SITE PER MFG SPECS X ASTMC143 ASTM C138 X ASTM C1064 ASTM C173 X ASTMC31 X ASTM C780 OTHER Inspector KAMERON BINNS wh Laboratory Data Design Strength 1,800 @ 28 days Date Specimens Rec'd. 4/7/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb = Area Load = Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type X ASTM C109 P17630 4/13/2010 7 2.00 4.00 0.0 3.14 6660 2,120 1 ZL 1 |X ASTM C617 P17630 5/4/2010 28 ASTM C1019 P17630 5/4/2010 28 Other P17630 H Test Results Remarks FR #119424 Conforming Results Reviewed By wy Date Reviewed 4-13-ic Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Rowson O Effective Date 12/02/02 The intormation 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 Krazan & Associates. Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-100051 Weather PT. CLOUDY Project JEFFERSON HEALTH CARE Location PT. TOVWWNSEND Client JEFFERSON HEALTH CARE Cyl. Code P17619 Pour Date Jurisdiction CITY OF PT. TOWNSEND Engineer Architect 4/6/2010 Report No. 49089 Permit No. 2009-4 Contractor WINSLOW MASONRY Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. Site Mix X Design Actual Initial Weights Weights Flow or Grout Air Max/Min MixNo. DESIGN MIX Slump Temp. Temp. Temp. Cem. Ibs. 200 Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. - iZ.0f - - - FLUID 63 61 - C. agg. Ibs. 1 - C. agg. Ibs. 2 - Grout Box Used C. agg. Ibs. 3 - Number of units used to form specimens Sand Ibs. - Water Ibs. 6gal Placement Area Air Ent. (oz) - Location CMU WALL MRI SUITE 0-32" FROM SLAB Other (02) - Other (oz) - Other (oz) - Other (oz) - Water Added on Job (gals.) Field Test Methods Remarks MIXED ON SITE PER MFG SPECS X ASTM C143 ASTM C138 X ASTM C1064 ASTM C173 X ASTM C31 X ASTM C780 OTHER f Inspector KAMERON BINNS g Laboratory Data Design Strength 2,000 @ 28 days Date Specimens Rec'd. 4/7/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type ASTM C109 P17619 4/13/2010 7 3.00 6.00 0.0 10.82 45435 4,200 1 ZL 1 |X ASTMC617 P17619 5/4/2010 28 ASTM C1019 P17619 5/4/2010 28 Other P17619 H Test Results Remarks FR #119424 Conforming Results Reviewed By 7 Date Reviewed 4-19 -te' Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% oiisia Effective Date 12/02/02 The information provided on this report is prepared for the exclusive use of the client. This report May Not be reproduced i any format without the written permission of the client and Krazan & Associates. 3K razan FIELD REPORT NO: 774972 & Associates, Inc. GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION fe DATE:_ <4—7-70 CONTRACTOR: 47K ABA) PROJECT #:__ “0G -/OOK / JURISDICTION: OK 7 7OtU WH EYO) PROJECT: Wi, t; PERMIT#: 24D /6 -OOF LOCATION: (ORT TOtwOps4r PD | INSPECTOR: (472A (A GALL 0 KRAZAN PROJECT MANAGER: _\ #727 A WEATHER: QO’ TEMP: Az OM S/7T# (OR KB67s40 Y~oEPECTIOW , CKBUTO SP 2 AOD CORSTIMUOUNS rv sPCorion) pre CoaetT Pie byntp)F HKG CROUTED LUAS weT WwAle, CGxk2UT lus JBY JRUTANL LNATEIMLS CGOAKSE GCGKDU S?TE f77/KGO, | SA’ Bass (44040 Br BucKers. OVE <Anwke pwwys LLHKGEAS 2d Ofer 1 682r- 2 4 AicYy Ckouer Cc1ges [2k _COmtIRESEIOW) TEET IR. 6EA CREA ASIER OL SFBOLEIC pO FOLM ATION, CORS0L(OATED BY ROW BLE WAKA For, CROUT- ~$44CER fA BX SIFTS, AEETHEL Phacip ALC Oc, UWUEBMCH Avr 22 oc Ge AOOINZ DBL? THE VA Ge AZG6TZEc ZITO ZX ISTO the LR FE dJ-E-so cr = TOrnmL. 6/2 EF Of WAL GeoemZ® 7) _ BR AVETS CR _ FEIsS> Equipment/Asset Number(s): To the best of my knowledge, the wrens) WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Represéntative: iad) ie O b rior to final submittal. By signing this report, our on this report is prepared for the exclusive use of This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review, inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. The information provided the client. This report may not be reproduced in any format without the written permission of the client and Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 EFFECTIVE: 4/22/2009 DAILY FIELD REPORT 2009.doc Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-10051 Cyl. Code P17618 Pour Date 4/7/2010 Report No. 48982 Weather O'CAST Jurisdiction CITY OF PORT TOWNSEND Permit No. BLD 10-004 Project JEFFERSON HEALTHCARE Engineer Location PORT TOWNSEND Architect Client JEFFERSON HEALTHCARE Contractor ANDERSON Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier MUTUAL Plant No. Site Mix X Design Actual Initial ’ Weights Weights Flow or Grout Air Max/Min Mix No. - - Slump Temp. Temp. Temp. Cem. Ibs. - - Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. = = 12:20 - - - FLUID 57 48 - C. agg. Ibs. 1 - - C. agg. Ibs. 2 = - Grout Box Used X C. agg. Ibs. 3 - - Number of units used to form specimens 1 Sand Ibs. - - Water Ibs. = = Placement Area Air Ent. (02) - - Location MRI WALL SECOND LIFT Other (oz) - - MUTUAL MATERIALS COARSE GROUT Other (02) - - DESIGN MIX, 80LB BAG. Other (oz) - - Other (oz) 3 - Water Added on Job (gals.) - Field Test Methods Remarks SITE MIXED; MECHANICALLY CONSOLIDATED TWICE, X ASTMC143 ASTM C138 PLACED BY BUCKET. X ASTM C1064 ASTM C173 X ASTMC31 ASTM C780 | OTHER Inspector BILL UGOLINI Q Laboratory Data Design Strength 2,000 @ 28 days Date Specimens Rec'd. 4/8/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb~= Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type ASTM C109 P17618 4/14/2010 7 3.25 6.00 - 10.59 46235 4,370 ZL 2 |X ASTMC617 P17618 5/5/2010 28 ASTM C1019 P17618 5/5/2010 28 Other P17618 H Test Results Remarks FR 119973 Conforming Results Reviewed By y, Date Reviewed -/4-/e Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Form 04103 Revision 0 Effective Date 12/02/02 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 Krazan & Associates as =S e235 FIELD REPORTNO: 7} 7898 42Krazan & Associates, Inc. Ao GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: ¥-E-re CONTRACTOR: ay» WSton MAsewi2y PROJECT #:___ <6 + e050 JURISDICTION: 27% 4 Fr Gants PROJECT: Uersrsan! WGK Ones PERMIT #: Zod -¥ LOCATION: “Pr acdsexnedD ’ INSPECTOR: _4la rex) CLUDE KRAZAN PROJECT MANAGER: ___ 7 y WEATHER: 427 Cereed 4 TEMP: “° momacnanarse LUanGAA PEPRESENTATIUS onl Sar feu7 GY AO TECTIch! Ano Gitourl FRACEMEWVE. OP WE Sure. KEPPESEMATIE OBSERANSD CENT eR RK SOS AUR SPR BY Resa Mire. CaeMRATOR FtAtuxn Geer - ExiStuvg Cars Lee CNG Reoxedty, Arlo NEW CAA BRILL iy BUM EEPRECENMIAE REZVEQIED PHAWS Aid NOTE) BR 77 FRE Re. FONE. Biter Peace CAG) APL From ConIBE /2 72 CoMmese /S§ ILETRESEVOATICS ORRYMED A SfatPUS PeR flees Fesr fet CAST fT OS 3XK3BXO Gtout srsCweneT, SEE 7ESr esr For Ssusexs CRW YPO7Y, Equipment/Asset Number(s): To the best of my knowledge, the above WAS, WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc EFFECTIVE: 4/22/2009 Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-100051 Cyl. Code P17619 Pour Date Weather PT. CLOUDY Jurisdiction CITY OF PT. TOWNSEND Project JEFFERSON HEALTH CARE Location PT. TOWNSEND Client JEFFERSON HEALTH CARE Engineer Architect 4/8/2010 Report No. Permit No. 2009-4 49074 Contractor WINSLOW MASONRY Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. Site Mix X Design Actual Initial Weights Weights Flow or Grout Air Max/Min MixNo. DESIGN MIX Slump Temp. Temp. Temp. Cem. Ibs. 80 Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash lbs. - 11:10 = - ad FLUID 54 60 = C. agg. Ibs. 1 ca C. agg. Ibs. 2 Grout Box Used C. agg. Ibs. 3 - Number of units used to form specimens Sand Ibs. - Water Ibs. 5gal Placement Area Air Ent. (0z) - Location CMU WALL MRI SUITE COARSE 12-15 INCLUDING Other (02) - BOND BEAM Other (02) - Other (oz) - Other (oz) = Water Added on Job (gals.) 5 Field Test Methods Remarks GROUT PLACED VIA BUCKET AND BAG. X ASTM C143 ASTM C138 X ASTM C1064 ASTM C173 X ASTMC31 X ASTM C780 OTHER Inspector AARON CLYDE Laboratory Data Design Strength 3,000 @ 28 days Date Specimens Rec'd. 4/9/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb Area Load = Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type ASTM C109 P17619 4/15/2010 7 3.00 6.00 0.0 10.87 41220 3,790 1 AC 4 |X ASTMC617 P17619 5/6/2010 28 ASTM C1019 P17619 5/6/2010 28 Other P17619 H Test Results Remarks Conforming Results Reviewed By Date Reviewed 4-1 "/0 Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Form 04103 Revision 0 Ettective Date 12/02/02 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 Krazan & Associates FIELD REPORTNO: *} 7 742 ff 3 =2Krazan & Associates, Inc. GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION pate: “43/2 contractor: AW dagen PROJECT #:/06* /005/ JURISDICTION: Gy of foe? usw sonT? PROJECT: SefESOY flALth (hte, URI Suilé permit #: ik 22-204 Location: P&L Jor $en J | INSPECTOR: jm Shu KRAZAN PROJECT MANAGER: _ S72 = WEATHER: yee Pk. TEMP: GA ~ UkA2AN Iyepectok on site foe Gooxy fychoR_ynspection pt Ast tall, Centée pntill page S.A. foe facatron, Yee “GhowOl _ pak e 9- ard /4. Yith2An /vspectoa Reviewed plAN€ Av found foles at top AN Ugttom Comtem tO f/ans, Yebtical Location pt heft wo Aiside at apenwny /$ Spaditiled duo to hollow CMU Wal. (ne peer af Record “houghlin- Meter’ hunden” fdve aApppoveI use of Hollow lal Awchog Sleeves , onthactoe And YRAzAn )nSpect sk Lidve Aspostel B.El. Bet Conformance, ia ebsxepveD All holes AeiNe2 xe pike mnsthuctiocs, al hikes weee cloaned ta myty. pristhuction (plow borusblow), Suv ARCAS oF BAKO @ouetete vA #5 hobs “WAS PieeD to A dog of ¥’ toroter uth dn sdecoate Amoent xt Simpsov Sot 22 Gpory, in fhe “at jollow CNU whlh follow wall Aneholg ywWore plhed.) A MIN mum of 6% jn depth efoxieD Ano Then a XSF bft was svete) po 1, diseetione Cpitrtionl Date Fmpson GelOX Epovy = be- 31" it HRAZAN /Wspectoe bequest) > standby while cote gize poles were BNE AMO cfeaned tp 166 puofhye7 on? Equipment/Asset Number(s): K6ibin To the best of my knowledge, the above WAS / OEE performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: Ai Lloxy This report indicates our inspector's observation and testing results based-on the site condition and contractor's acfiwfies. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provi by others on site. 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 Krazan & Assoc. Offices Serving the Western United States . Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc EFFECTIVE: 4/22/2009 Pe ee SSK raZan «associates, iNC. GEOTECHNICAL ENGINEERING @¢ ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING & INSPECTION April 27, 2010 KA Project No.: 106-10051 Building Permit No.: BLD10-004 Ms. Dana Michelson Jefferson Healthcare 834 Sheridan Avenue Port Townsend, WA 98368 RE: Jefferson Healthcare Tenant Improvement MRI Port Townsend, WA Dear Ms. Michelson: In accordance with your request and authorization, the following test data are presented on the following reports, which are enclosed: April 6, 2010 Field Report No. 119424 April 12, 2010 Welding Inspection Report No. 8529 - WIS Referenced concrete reports and compressive strength data will be mailed following 28-day tests, if applicable. If you have any questions, or if we can be of further assistance, please do not hesitate to contact our office. Respectfully submitted, bo~ Sk, Penn Seely, Laboratory Manager Peninsula Division PS: md Enclosures CC: City of Port Townsend — Fred Slota With Offices Serving The Western United States 1230 Finn Hill Rd NW Ste. A e Poulsbo, Washington 98370 © (360) 598-2126 © Fax: (360) 598-2127 43 FIELD REPORTNO: |. 424 43KkKrazan & Associates, Inc. _ GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: b Aves\ 7.010 contractor. AND225¢ rv pRoJECT#: lO * [905 ' yurispiction: Cty of QT Tow vSEWd PROJECT: JZPELROON Keath Ude PERMIT#:__$LD |O- OOY Location. YoeT TowNsénirz we | inspector:_KAvUé Low BinnS “a . KRAZAN PROJECT MANAGER: WEATHER: (Wines 2 ca TEMP: (g/ ° KeAzan ep on site Ak Reousst of Conteactor [Foe Sthuctu@al Mrsority Spzaal Tvspection) . STEVE DAULZ02. GAVE Verbal wpfrovel foe on ots Mii 9 &* Gout Calofo); REL, jo Fallow. (obwitacore Betun heaem bl ot CMY. wAllL iW WMWeL Qoom, Meetae USED WAS Design Mx PRO brane THupe S MoetTae. “) 2X4 cou pecc#ar) SA F fee lh6 tect Data. Se C2 4904|' foe Details DeSitn mi Peo tance Conese Clout mix Wits Sits MEO AU Plarz 1) SAiD wAll ~t 0432" Litt. (4) 3x6 (lompessiod stmples CAst For lab TéST Data. See. (C2 49067 foe petals - ( 2) Seartbe’ Poisms (net fee Genecal Motes Roe Cowe SSiOM Test ~- See (2 49010 FoR DéTRls Rein {eee vo STL oBsBeVvED to Bs 160.0. Vontonl, aun 22" 0.0. Hogizortalhe spi ficahows At sHest S~H_ 6 £ peoven flan - Covteactoa Tied Rewhosaue srzel into EXISTING OMuU WALL Ps itpsw dicular to Copsteucep will By PAM NG iwto TwteCi0_Ws HBIV Awd PiKcin’ Re nloeein& $t<ecb 3” into Zyeistwe Hollow Cell And Equipment/Asset Number(s): C1] IN witty EorT Pee gid. KR. TystRactrows . REZ. To Follow. To the best of my knowledge, the above pe / WAS NOT performed in accordance with the S and regulatory requirements. Superintendent/Representative: Techyician This report indicates our inspector's observation and testing results based on the site condition and contractor's activiti ies. This informatio is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 EFFECTIVE: 4/22/2009 DAILY FIELD REPORT 2009.doc WIS DATE 4/12/2010 NO. 8529 WELDING INSPECTION SERVICES Inspection, NDE, Testing P. O. BOX 1044 SUQUAMISH, WASHINGTON 98392 (360) 906-4386 CONTRACTOR Andersen OWNER weldinginspectionservices@gmail.com PROJECT Jefferson Healthcare LOCATION Port Townsend, WA WEATHER N/A inside TEMP. ambient TO PRESENT AT SITE Contractor, Allform Welding Krazan and Associates, Inc. Andersen Construction PERMITNO. BLD10-004 Dana Mickelson f Building Official-City of Port Townsend, WA of Krazan Job No. 106-10-051 SPECIAL WELDING INSPECTION PER IBC 1704 AND AWS D1.1 Requested for third party, independent, special welding inspection at the start of welding. Arrived at the site 0815 hours, met with Superintendent, Larry Snow, reviewed drawing notes and details S-3, viewed Andersen Safety film, reviewed hospital and Andersen safety and work rules. Observed and inspected installation of W10x22 support beam, mounting plate to CMU with “wedge” type anchors, welding of beam to embed plate, joists to beam and embed plate, beam connection knife plate to mounting plate. All welding SMAW, E7018 electrodes, prequalified joint design per AWS D1.1. Installation of beam and plates and welding performed by Allform Welding, Inc., WABO/AWS certified welder (Shane). Mounting plate installed with 4, 3/4x6 4 wedge anchors per specifications. W-beam installed and welded in place per specifications. Joists welded to beam and to embed plate at top of CMU wall per specifications. Welded connection knife plate, mounting plate to W-beam web, installed and welded per specifications. Temporary bolts (two % dia.) installed to connect knife plate to beam web. Replace bolts with HS A325 bolts and tighten to specification (advised Superintendent). All fillet welds inspected with light (16 welds total) and ACCEPTABLE PER AWS D1.1 VISUAL CRITERIA, MARKED VT-OK 4/12. We ON a Ken Havens, Senior Inspector, AWS/CWI, ASNT III SIGNED <A h ~& ASSOCIATES, INC. GEOTECHNICAL ENGINEERING @ ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING & INSPECTION June 22, 2010 Project No.: 106-10051 Mr. Fred Slota City of Port Townsend 250 Madison Street Port Townsend, WA 98368 RE: Final Letter Regarding Special Testing & Inspection Permit No.: BLD10-004 Jefferson Healthcare TI MRI / Port Townsend, WA Dear Mr. Slota: In accordance with our client’s request and authorization, we have performed special testing and inspection services for the above referenced project. The special inspections for this project were: Special Inspection Required Performed Structural Steel: - Welding XX] x] Bolting Xx x] Reinforced Concrete Xx x Structural Masonry X Xx Expansion/Epoxy Anchor Bolts X X To the best of our knowledge, all work and noted deficiencies have been tested and/or inspected and have been found to be in accordance with the approved plans and specifications. If you have any questions, or if we can be of further assistance, please do not hesitate to contact our office at (360) 598-2126. Respectfully submitted, KRAZAN & ASSOCIATES, INC. rm\ fF MA ce of ] fey Dowt>- DE eiVe py) Jeffpéy M. Bowers I) || ] Construction Services Manager lI LI yy i ) J] Poulsbo Division } oo — Ls JMB/md CITY OF PORT TOWNSEND cc: Dana Michelson — Jefferson Healthcare Bob Miller-Coates Design Larry Snow-Andersen Construction With Offices Serving The Western United States 20714 State Hwy. 305 N E Ste. 3C Poulsbo, Washington 98370 © (360) 598-2126 © Fax: (360) 598-2127 FIELD REPORT NO: 119595 42Krazar. u Associates, Inc. GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: Qs /atf/ Aao/2 CONTRACTOR: A WV DEX Sv ‘PROJECT # /O6 -/005/ JURISDICTION: C74 @ shor Jou sewe PROJECT: J€ F4FEXR Son KéaL7H Cape TEMAWT PERMIT #: LOCATION: Je e424 #50" Gevenae //OS ise INSPECTOR: 4 oWF4¢ DAES KRAZAN PROJECT MANAGER: TB WEATHER: Jonten C tone, VEMP: 50° 2 43 A RAZAN ZASEPECTOR OW SIZE F of J “RopRtETARS ANCHOR FNS PECTION RFI“ 39R2 TRANS Fow/ieER rat ZOCATlowv OF work, OW THE Roo, 45 ER Two /6¢RAPEl WAL §$ Soran FD A LYSIDE coV¥WwER, AS Su J2Q2ORT . ULsAHE RF Bu is7ore J?2 £ EAE? STEEL A THAT tee wlede) Ann CACvINIZED , Aupporstnaligy Brgy Fees LACH Dipeecrtionw .§ ARROW THE Pa sipk CORWER, ’ . ' et _ _ _ . . Hetfs bh EKE DwrreECc Fy) /2"'Q-¢ Pe 2 os Mb Za RI46 2,7 TNto Foe fbey i SHE ¢ Ss’ - - 4 - VAGONNKG poe ILC 4 LYN fol Di tetvor: & ARGRe riers) ity g fot 19 4HsetBey Fofsic., THE NoRTH 324TH Hu pwinwe weet OF PHetésS was Hodsou 3s £0 PIACGNRY GQ Se EEN S ae were Ast) £4" Fu enmen sl OF %g Zig £ THRE ROL) oF 8 HelE S Faceu vrep En OO Se Sos ers? we 5 TBE £4067 44EST fee eg tse wie 6 | as / Ftd S&S bee KE Sf Zé WweEnNeE Anctog floss tv Eewe ww sey, a =L) . OO ~ hs TA E FD ad SE ME ee a a ee ee Pe i a wt Kwek fPlote ote ayy ri Dap icf i f3g 2 Seo REL NS AnD EPOX, WERE UsFO, Teg £ st 26 SL te bie fe oD y, - - ~ oe ; , Holes weep ep eens) best vo ha mis OF SFO Pi atv) ante Pek erat fv sHid §$ 268 Spy 2eow EA2AKS LEAN ee ECT RARE Se TA oF ate CF es} Laz aid Z-2 3b FB Ger, weet A Exy2¢ Ra Teas {JA TIE AF ag/loz/i. S141 220H SFT. ff vex « eet > Oe SFO. IS PER TFTNVSTRACTOON GC OOF pig WG Ete Fit ie Foot Alo ge ote LEO NEY Kt le. Equipment/Asset Number(s): To the best of my knowledge, the above WAS }y WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Représéntative: Technician: eae el. ZL in Asay This report indicates our inspector's observation and testing results based on the site condition and-contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. = Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 EFFECTIVE: 4/22/2009 DAILY FIELD. REPORT 2009.doc 422Krazan & Associates, Inc. ™ __INDER REPORT NO.: 47299 GEOTECHNICAL ENGINEERING »* ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: 26S/6l 2010 CONTRACTOR: 9 vw DE250ON PROJECT #: pone JOD ks PERMIT NO.: BLO-/o-co¢ PROJECT: teves 2s0w We oe rat Cot wb SEMAN INSPECTOR: LOiwk sf bIA tt § LOCATION: Se¢eecscon G@éweune Hoshi JURISDICTION: C476 oF /bxeF Jepew 2F assy KRAZAN PROJECT MANAGER: TZ WEATHER: “a fewer TEMP: ><) * Field Data Reported Batch Data concrete [rr ontan | Mther| 4 CementType|_ sg ze —_— Desi Actual] 4” supplier [> ona te Ins} Plante. a site Mix [>| esign |____|actual|__| Bata No. JioxtTaR Wyre § Mix Air Unit Cem. Ibs. - Slump Temp. Temp. Wt. Time Truck# Ticket # % Air (in) (F) (pcf) F. Ash Ibs. fasll- CI Gel) |) on C. agg. Ibs. 2 Placement Area C. agg. Ibs. 3 Location JARI) DoweR INF :Leé Ss, AAT MERI! Sow tl Pu NN Sand Ibs. tur ee, Water Admixture Other Air Ent. (oz/cwt.) Remarks] ¢ 22 ep AT. fou rt ConxRStE AP? i 14 be ees S| Water Added on Job wea [R)\ r\\| (gals.) 4-4 | - = 2 1ij _ 11{ Field Test Methods Please refer to Field Re sri 42 QaGhG Hs | astmct43[y | asTmciss[ | ae ASTM C1064 [| ASTM C173 [| Inspector |. LE iD c. | L__ — ASTM C31 x_] CITY OF POR! TOWNSEND Other [| Laboratory Data 28 days Date Specimens Rec'd. [| Cyl. Test Field Max Comp. Tested Break Code Date Cure Age Dim. Area CF. ‘Load Str, (psi) _Set# By Type wae Mlathok - est Method 6/23) 7 Igy: _|| astmc39 [| LLY ZS astMcio9 [|_| aly Le astucei7 [| asTuci231 [| astmcioi9 [| Test Results Samaiie [| Conforming [| Non-Conforming Results Reviewed By | 1. Cone 2. Cone & Split Measurement Uncertainties: ASTM C39=Cores +/- 8% Codes for Break Types: Date Reviewed fe | 3. Cone & Shear Al 4. Shear 5. Columnar (Split) | am = ~._INDER 423 Krazan & Associates, Inc. REPORT NO.:: 47298 GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: OG/6/20-0 CONTRACTOR: 2 4/24 « SOM PROJECT #: yog- soos PERMIT NO.: PROJECT: serecewocanny Meru Care Seen INSPECTOR: LOL 2 LL (24 tr4t > LOCATION tees 4nsaw @ewraere Hosted JURISDICTION: (7 )7_ oe /hvr Jou age wd KRAZAN PROJECT MANAGER: 327 WEATHER: OLC AST TEMP: 50°. - Field Data Reported Batch Data Concrete| Geer z | ther | _| Cement Type|__-Z -_27_| Supplier |. al Plant No. -——— Site Mix |X | LX | Design | A | DE SING ity Xk CoOsRsSe eae MONO. ex, 7 kL OINSE ‘ Mix Air Unit Cem. lbs. ' ; Slump Temp. Temp. Wt. Time Truck# Ticket # % Air (in) (F) (ey (pcf) F. Ash Ibs. Gelb IL IC dh eel] || om C. agg. Ibs. 2 Placement Area C. agg. Ibs. 3 LOEAnON m Al, DooR DHF L065 BT Moat, 22% TH we ee Sand Ibs. A GX Gg T8tE Opening AWD A BxKS TALE OPEN VG — JOE IN Fock MENT CON Fos@ernrs; He. 6 “O.C.E ubey Admixture FAT PL Other =e LS yey e- Air Ent. (oz/cwt.) Remarks Lees 9 “~ ED AT FZ PARSE af SA 7 ‘ (ili - 1 Water Added on Job uu | (gals.) 2, i Field Test Methods No. 120296" D AsTMc143[ | ASTM c1s8[ | ee 7 ASTM C1064 [| ASTM C173 [| Inspector | - MO Derecs ASTM C31 other [ _| Please refer to Field Report Laboratory Data Design Strength} zoco __| @ 28 days Date Specimens Rec'd. [| Cyl. Test Field Max Comp. Tested Break Code Date Cure Age Dim. Area CAF. Load Str, (psi Set # By Type Laboratory Test Method 6/23 7 lhyive’ | ASTM C39 [_] L..] Zhe 23 |__| ASTM C109 eee ; |e se astmcei7 [| H ) asTMci231 *[ | astmcioia [| Test Results Remarks [| Conforming Results Reviewed By | Date Reviewed [ Codes for Break Types: 1. Cone 2. Cone & Split 3. Cone & Shear IA 4. Shear 5. Columnar (Split) | Measurement Uncertainties: ASTM C39=Cores +/- 8% ) FIELD REPORT NO: 120296 43kKrazar. « Associates, Inc. GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION: TESTING AND INSPECTION DATE: OG “44/2070 | CONTRACTOR: _4vnex sow PROJECT #:_~ OG - 4007 JURISDICTION: C74 2 (Get FowwseEw VP PROJECT: JéF+4¢50w #2 9erv Cc aRe TEWAKT PERMIT#: £22) /O-o@¢ LOCATION: 3 44442 8:04 GEwewsd HosstiTAe INSPECTOR: 4owe4Z /) 41 9 KRAZAN PROJECT MANAGER: Tt WEATHER: Q/ecIgs7 TEMP: 4,0°5 —aaeeaeniien A RAZAK TAWS PECOTOR OW SITE FOR 2 KE foceiwGe UT FEE ZN SIE 4 or AL IRE A 2a err, N20 lt 4A GS ZTWFLEL S ThA SS“ cme £xXotsTINn Ge WAee Tie DOOR WH4IG 5 WERE £eLcF OSM west) 9 We awe xe bse fie" CF, tty, GrouT ZOD Sadr. LO Bae COW KS ES WERE CID UP AAD 4O codgersts Ff ON FHL @ wrné Docr- fe Rouel ED bet JYt RELA we EAL PLACE To try s-ornsT CORSE S tw E£NE £Zappnp AAD /O cc OPK Sf2 GRoeu TE SY, Gott oe oe) mr OA TAM LZ Ate PVE DPo2kwi yrs. get tt AE sid 2 TN (76 Ae FF FO FHS feet THAT 4.5 Aopwiy Te coortowtis Fo 27M KROWwF ti L2LAKMS DEAL SLL ON SHEET RS ead A fw GESO AS NoTeD TX ARABZIN REPRAT NATED BCbEBLY/ESA012 ar LAL say 44 TNALELS AOUDIZ OWT de hey las E “4 NE LAR 4 - . ae RE LACED ns LTIt, Pe We be = Eryn P£D 2v£aAarZ DEAS H rw (EUS TT ee BREW Eow EER CAN br GL 2 All E Paky » Alortar “SED was Desienw WIIx TyPe GS 4 is arywileé wets Letely vol “en ft THE Frertett Poa 2TH Awe sf ty). QWF SF7 OF e=— AX $Me om pH Soren FEST Sones HoT AVP Fer TEST ZITA et EAE omg ST NEFLBEMCE <ghracDe a VE spor ROA usFD pe IS IDF Sr GAs MIX Cogn ok, LP btn DEE b/AS Taker AT ~ * PAE Fy SH KO desk L4f OQAE SET OL Y= BR GC" Coe PRE GSI NW TE ST SOE S bt EA WME “AST. Flax y “a SED nate vel afta Ex ije t[ ow F 6214 50m SEI LFW 0973099 ¥ VERTIS AND 4 HorizAnstany LNSPAEEI VIE BBY AM UAC ARES LAST RW CLION Sy be ft TFL Se PBF KL So = me 7 \ PRISM - OfF SET OF PRIsns |FO BL RACE FOR N\NEXT AGS GRogT AAD JITORT PAR SIT THIS LOCATION? Equipment/Asset Number(s): To the best of my knowledge, the above Gas) WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: Sen 7™~ , LL) een eed This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to finat submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. The information provided on this report is prepared for the exclusive use of the client. This report may not be reproduced inary format without the written permission of the client and Krazan & Assoc. € i Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 Nall V EIELN REPORT 2009 dac EFFECTIVE: 4/22/2009 FIELD REPORT NO: 120294 43Krazan « Associates, Inc. GEOTECHNICAL ENGINEERING ° ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION CONTRACTOR: “7 AAD FSO AL PROJECT #:_ 426 - /Oo0 57 JURISDICTION: ¢Cv7y cF Pa et J eteNEE ND PROJECT: SAE eER SOW HEALTHY CARE PERMIT#: (207 soa-an% LOCATION: 3¢ 4442504" Gen Ed se Kos Gi7At INSPECTOR: Low £¢t. Fw % KRAZAN PROJECT MANAGER: __ 7.2 WEATHER: coy #2 TEMP: 25> DATE: CG-4¢/acleo KRA2ZAN _KEPRESEATAIIC EA OW 5/7 E FOF (RO PRIEF 1 bey BAC Hop £MELECFL ON. 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LPS PER KAT F Fo STAIZ = LAAET Se KREEX 3 ye (hi LBE &h& SZ) FOR CON RE Fe WweE/Y — ft *t Cr 3 LUA ALL GA Se ae a FA fEOowieas 7 tee LLP BE REL HW 2 72,7. for THe S0/éPD F420 Atertt HOLED ke ! oe L, ¢ A OnE Zane 4 [227 Fok THE Ze Se KELKS evr Wose + MRrec ED 4 LZ Mota Mit mati Vee, Aru) Naaicxr [2.82.5 2. 7 TOotAe QE BE A ofA ye DRS ABAMD, €2LecIALE Db ZEE Sam 2sOr SEF fi aox, L107 “OF 3022, bet let Ex Fit OT, Ope LD@e@FA ae tol22f 2020 bec & 1% SLD 4S PLR AIAKMUAB CTA RFS ZMASTRACT IDA, ty/e REBAR CAMEO O15 FO A P2PPOwED DAAALZS Let wctitt Moles oe S46 T S ee a MAELO AEM 5K Zi W@EGAR, Lh” 2 Ft alt tt dt ts (ht Apr ais OF QALL2 DeETap2 LE aac 6B ALET Two LJFR Each KPuy BPI _ ZS POE L277 D4 AY Q2aZ “aT Awe KH aoe 4. tS a 2 — > * 2 a {LE LEAT ow moat FT DT DE a VD Ke ha 6 /35 ARS ge = . ge GO SF LFRT? ZA FH 51% 7oo7 DMF th. te thé M1 PLACE L MOF PF pg FE ge ee Fi Oe Jo 2 ed te pe Cat T Te Oa a | Cc | i ™ \ : Hd Ss = nl = Fen rT In) UL % L af M 4 | | ] i] | he kk | . - he Al Equipment/Asset Number(s): | a | =e ae a To the best of my knowledge, the abové WAS) WAS NOT performed i in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representalive: ~ Technician: Fee —— ai LE of p2 ae . ion is subject to review prior to final submittal. By signing this report, our The information provided on this report is prepared for the exclusive use of — This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This informati inspector does not accept responsibility for validity of the results. Some information on this réport may have been provided by others on Site. the client. This report may not be. reproduced in any format without the written permission of the client and Krazan & Assoc. Offices Serving-the Western United States Bothell 11 (425) 485- 9519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 EFFECTIVE: 4/22/2009 Naw cict A OCDADT 9NNO dae FIELD REPORTNO: 1419771 a — 42KkKrazan | === . Associates, Inc. GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION pare: OS /9- ZO CONTRACTOR: “Y“ OFKEA+) CA ISB? PROJECT #:_ 26 - O~ JURISDICTION: _ 4 7= PROJECT: (7 EF 25a.) PALM ARE, PERMIT# 24D 10 -OOF LocaTion:_f=7- INSPECTOR: (2/ZZ. (Gehre/ | KRAZAN PROJECT MANAGER: ° WL2L2 WEATHER: S/n ) —— Ce OA) Ss Te FOR LU ALL IPI Lo oe) ATH SU PORT SORICTURE Wthé Pee Cer. ~*~ GE? OF S-¢ BY CP Aum Pll sys. [9 8 PVRCTH OD) FOR FILA ET LUELPS UZY THEY Lip OBER, C01) FORD TO WL WAG WELDER SHWANC HAGEAR a = FUE Gc LW EIS IN) ——— IL} ju HL jf | ———__] Equipment/Asset Number(s): To the best of my knowledge, the above / WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician:/ i ~ MDS Jae [) if i J) / Ay Peat ‘ i Ls Lod tll i vf bt By signing this report, our esults based on the site condition and contractor's activities. This information is subject to review prior to fin Some information on this report may have been provided by others on site. The information provided on this report is prepared for the exclusive use of This report indicates our inspector's observation and testing r inspector does not accept responsibility for validity of the results. the client. This report may not be reproduced in any format without the written permission of the client and Krazan & Assoc. Offices Serving the Western United States - Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 ‘ EFFECTIVE: 4/22/2009 DAI Y FIFI.D REPORT 2009.doc / SS €3Krazar.. ashoctates. a FIELD REPORT NO: 120331 GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION pate: “2-_) o7 10 CONTRACTOR:_ialae sont PROJECT #:_1 0 b= \OO*S JURISDICTION: (25 P7070 Qa tS evicd PROJECT: eV tersonl Healdvcace PERMITH#: LOCATION: $ Nee iAerl Ave _ INSPECTOR: —) o«¢ (> ~gclvic) KRAZAN PROJECT MANAGER: yw \© WEATHER: O° ( «3 * TEMP: & 2. Onl Sve Wer 25. vesr For Specia\ TaAlspyecX¥on OF EX gansis sel pico Yon Les. Conteacker istatled jo 2X 1 anld ‘a= NS /3 x AX Soprporx SAcuceice ar TOs ec ale eS 6,8 on) SY. Controk*tor Cleaned holes aitd Vilstatled oo onl anchor WolkS Widkhw & wialwow S" of embedmentt Dek aler And Veragued per Specivicarwnrs. | § V \ i Equipment/Asset Number(s): To the best of my knowledge, the abo (WAS) WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Représentative: Ne" P asda This report indicates our inspector's observation and testing results based on the site condition and wnea te 's activitjés. Jhis information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided thers on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc EFFECTIVE: 4/22/2009 f n i =2kKrazan & Associates, Inc. FIELD REPORT NO: 117924 GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: 4f-€ -}o fo PROJECT #: /O6- PROJECT Effie eh HeallORl mer Te LOCATION: $3.74 SAe2coe 7 KRAZAN PROJECT MANAGER: 3/72 CONTRACTOR: GLOELSY Lor fT. JURISDICTION: 2¥'¥ af Poel Cotwyse Lip permiT#: (SCO _/o- 00% INSPECTOR UE FE Beau fies WEATHER: _Sc nave TEMP: S/° } ON et Hy OE do write cyst allolt ad RE AFTEEL Rou LC ssh Essel SLGR, Pts dowsls €preco cielo WAR Bb” wodt Smsaye SE77 | m ; . Ep) bs ee eben Is 24 Sheet SY. OLE SED shel Lal Manwery luok flee wt tie Abert Debs: AO Bleck (lLbOcCEp they nel. AU Wok py MR _hopeweg Pay Equipment/Asset Number(s): LZ To the best of my knowledge, the above WAS / WAS NOT performed in accordance with the a plans, specifications, and regulatory requirements. Superintendent/Répresentative: ural) Yj. —_——— This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This He is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. The information provided on this fanart is prepared for the exclusive use of the client. This report may not be reproduced i in any format without the written permission of the client and Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 €:=Krazan & Associates, Inc. GEOTECHNICAL ENGINEERING + CONSTRUCTION TESTING AND INSPECTION ENVIRONMENTAL ENGINEERING UrLINDER F REPORT NO.: 49091 pate:__{y Ape { 2dt0 contractor: A VD¢ oer PROJECT#: [0f, /Q0g'! PERMITNO.: Bf jO- 2044 PROJECT: jo FEZMGON HEAT X CALZ inspector: Khe tov BinwS LOCATION: PA2T TOWNSEew 0 Wik JURISDICTION: & ry O04 fpet TOwnse “xD KRAZAN PROJECT MANAGER: THA WEATHER: Zea t 22/2. TEMP: {, 2° Field Data TUPé S$ Reported Batch Data Concrete | —see | other | MoztAe | Supplier | PEG ry Aa LX | Plant No. Site Mix Remarks o”. 24" LET Free slae. Peeoaeation fae MF. Specs | Please refer to Field Report No. Hg 424 Mix _ Air Unit ; Slump -Temp. Temp. Wt. Time Truck# Ticket # % Air (in) (F) — (F) (pcf) zs |_— |L— | | — e277) — Placement Area Locationn yan wat mel Rodm Cement Type | =f. | Design | x | Actual| a j y; Inspector At 7 ZZ = Mix No.| SS/ Sl Mis Semen | bb # F. Ash Ibs. / C. agg. Ibs. J VA C. agg. Ibs. 2 Pa C. agg. Ibs. 3 Fa Sand Ibs. water] Bg al Admixture ¢ WA Other vA Air Ent. (oz/ewt,) 4 Water Added on Job (gals.) Field Test Methods astm c143[y | ASTMC138 [| ASTM C1064 i] astuci73[__| ASTM C31 Other [| Laboratory Data Design Strength @ 28 days Date Specimens Rec'd. [ .- Cyl. Test Field Max Comp. Tested Break Code Date Cure Age Dim. Area C.F. Load Str, (psi) _Set# By Type 2, of | | | | | _ i =r a ely 26 Hn [~\I . TT ty — =e 7 Y kad OU + al T t L Remarks Results Reviewed By Codes for Break Types: | 1. Cone I 2. Cone & Split MI Measurement Uncertainties: ASTM C39=Cores +/- 8% Date Reviewed [ 3. Cone & Shear AI 4. Shear 5. Columnar (Split) | ASTM ASTM ASTM ASTM ASTM Other Laboratory Test Method C39 C109 C617 C1231 C1019 [| | IL Test Results [| Conforming [| Non-Conforming €:5Krazan & Associates, Inc. GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: & tAgerc!’ ZdlVv CYLINDER REPORT NO.: 49089 CONTRACTOR: PROJECT #: Ing. 1O0S | PROJECT: SérceZsov HeALtH CBE AWwoe 2sBpy PERMIT NO.: B) dD Jo~ O04 INSPECTOR: LOCATION: Poet fowWsevo Ps KRAZAN PROJECT MANAGER: YMA KA ws Zon FYNVS TEMP: pl? JURISDICTION: (1, tu of feet Townse vi) WEATHER: 7 712 210 ¥ Field Data | Other] GQouTt Concrete | | Supplier | 935160 Woy Coaess Grout Mix _ Air Slump Temp. Temp. Time Truck # — Ticket # % Air (in) (F) (F) Unit Wt. (pcf) | Plant No. [ ———_] Site Mix b2s67 JL — LE LE ae" dea let — Placement Area Location anu wALL : Wi ét Loom 0". 32" Lift Keom §1AB. Remarks WrYEO oN aite (ee MEG Specs. Please refer to Field Report No. | \9 4 Z 4 Y Reported Batch Data Cement Type | > -0 Design | X | Actual| _ | Ky t — - ri 2 i 7 ia MixNo.| 2.0 6LApS Vas VA OS. Ibs. 200 # F. Ash Ibs. / C. agg. Ibs. / C. agg. Ibs. 2 1 C. agg. Ibs. 3 /- Sandibs.| * Water 6 G_ Admixture a) Other ca Air Ent. (oz/owt,) a Water Added a a ASTM C143 Field Test Methods astuciss{ —_| ASTM C1064 astuci73[__| ASTM C31 Dz ] Other [| ¥ x baal Laboratory Data , Design Strength @ 28 days Date Specimens Rec'd. [ Ce tee ‘cae Age Dim. Area CF. ee Ps (psi)__Set# ‘ere el rete hecines 12, 7 IBNYe ASTM C39 [] 6/y 1P —a| _| astucioo9 [| sft a& nr) | ain astucei7 “|_| , ok \ = eee ee el ssi cise) — TT ASTM C1019 | Te = omer ___] Cy UF PO ~ Test Results Remarks [| Conforming [| Non-Conforming Results Reviewed By | Codes for Break Types: Measurement Uncertainties: ASTM C39=Cores +/- 8% 1. Cone 2. Cone & Split Date Reviewed [| 3. Cone & Shear IAI 4. Shear 5. Columnar (Split) | €=kKrazan & Associates, Inc. GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION pare: _( APZi! Zoro PROJECT# [06 i009 ' PROJECT: S2EFS@s0N HEAHh Chas CONTRACTOR: PERMIT NO.: CYLINDER REPORT NO.: 49099 Anoz dsp n/ Bip lg- 004 INSPECTOR: kKAWse GON Br NNS LOCATION: _~a@t TOWNS2¢ND iw surispiction:_ Qty et Peet Townseny | KRAZAN PROJECT MANAGER: JWeB WEATHER: ff prteiZ1d2 Temp: £ )° Field Data PRIsSms Reported Batch Data Concrete J omer! "G Zou Supplier lp350gn Wve ~ | Plant No. Site Mix Mix _ Air Unit ; Slump Temp. Temp. Wt. Time Truck # Ticket # % Air (in) (F) (F) (pcf) Wig HL WL JL- i” ese" _] Placement Area Location dmanawall@ MRI Coom O- 32" Lift £dom SIAB Remarks Please refer to Field Report No. | | 4 At 4 Wixd0 Onsite Pen. MEG SPels . Cement Type 3-H | Design | ~ -|actuail LE. 7 Z ri inspector |V/Uilte~foeeF ti t MixNo.l/go GAADe CoARKE WA\ Xomps. 2.00 / F. Ash Ibs. / C. agg. Ibs. C. agg. Ibs. 2 J C. agg. Ibs. 3 YZ Sand Ibs. 4 Water Lo a Admixture J Other ] Va ; Air Ent. (oz/cwt.) VA Water Added "0 so) Field Test Methods ASTM C143, ASTM C138 [| ASTM C1064 ] ASTM C173 [| ASTM C31 | other |_| Laboratory Data ¥ Design Strength 1SoV @ 28 days Date Specimens Rec'd. [ Cyl. Test Field Max Comp. Tested Break Code Date Cure Age Dim. Area C.F Load Str, (psi) __ Set # By Type & fu 2 aie v 2% ID = TS iE TSE Sal ITT WW til | HI III ial PRI6m Fze To Be DetteLmwep At LAB Remarks a. Peisms Consttuctp 4-6/0 Results Reviewed By Codes for Break Types: | 1. Cone 2. Cone & Split Measurement Uncertainties: ASTM C39=Cores +/- 8% s Date Reviewed 3. Cone & Shear Al 4. Shear 5. Columnar (Split) | Laboratory Test Method ASTM C39 fe ASTM C109 [| ASTM C617 [| ASTM C1231 [| astucto19 [| Other [| Test Results [] Conforming [| Non-Conforming 42Krazan & Associates, Inc. DATE: PROJECT #:__{0{p Ve loos"! an rh , ' FIELD REPORT NO: 119424 GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION b Avds\ LOW contractor: ANDE2S¢N yurispiction: @ity of £27 TowwseEWh PROJECT: SEE FZR50N Ae arin Cade PERMIT#: @LD [O- COU LOCATION: 7o21T TowNsfi wh INSPECTOR: KAVAs ZoW BiNNS KRAZAN PROJECT MANAGER: ___)) ¥7_ WEATHER: “Le ig. TEMP: (5/° KeAzan leo ON site A*& Reousst of Cowtewanctog (Kok. Stiuctudal Masonitu Spzcal Tvsyection). STEVE DAU,202. Gave Verbal ArfeovAl foe on Sts MivNG nf” GRout “Calefa), RET, yo fallow. Cnwi@dActo®e Beeun Ase wa blu, ot CMU. wAU ip WAG IT QoOW MO@etaAqe USED WAS Design Mix (Qo beape lupe S WMorrac. Ma) 2 x4 Cos peessars Angles, Chot Coe lL¥e tect Data. “~s C@ 449041 ' foe Details, DeSlbN Miy Peo Grane Copese Gout mix whe Site. VAKED AUS Place 1h SAid wAL ~t 0°32” Lift. (4) axe (ipmplessio sAmules Chst Lot lAb Test DAtA. 6¢ @2 44905697 FoR petals - (4) SrA Peis s (ast Peg Gunecal Notes Kod dows 6Ssions Testi - 94¢ CL 49090. FOR. be TAs - Rein) foer iW STE. oBsERVED to Bs 16" 0.¢, Vouteal Anp 42" o.¢., Mo @izoAal ez Sled fithtiows< At SHESTO S-H_ 6 £ pphovte Flan - Covtedctoa Tien Remwhotaue Stzel ipto! Gyicti ne CMU, WA LL Peeps pn oeu [Ad to ddysteucttp Pra by De Wee into Imetwoe We PBIVG Awd PlMciING Re Coeeinl Ste<cb ZB mto. gyiotwe Hallow dell Anwd Equipment/Asset Number(s): €\t} iJ te wir ts Gilowy Pee a O. he= Tysthectrons . RET. To Follow. To the best of my knowledge, the abov / WAS NOT performed in accordance with the approved ae pecifications, and regulatory requirements. Superintendent/Representative: yee # LO This report indicates our inspector's observation and testing results based on the site condition and contractor's aktivities. This informatidh i in is subject to roview prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 2Ekr CYLINDER AZAN) «& Associates, Inc. REPORT NO. 49074 GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: +E 40 CONTRACTOR: PMNS bert MAS eV IEY PROJECT #: LEC — LHD f PERMIT NO.: vexoQ~ of PROJECT: 4 fe Sen! AeA oAike INSPECTOR: AA Zen! CEG AC LOCATION: yew FEamnSen? JURISDICTION: <7 77 €f 74. Feat Se v0 KRAZAN PROJECT MANAGER: wid WEATHER: Ft Ccoeey TEMP: “% ~ Field Data Reported Batch Data Concrete | | Other | 4 Gidea | Cement Type | pene | Supplier | WDESIEAL IIR Plant No. | Site Mix Design | | Actual | MiXNo.;teSidont |] APIA Mix _ Air Unit Cem. lbs. BO Slump Temp. Temp. Wt. Time Truck # Ticket # % Air (in) (F) (F) (pef F. Ash lbs. _ Cee | Idee T Je | ons C. agg. Ibs. 2 Placement Area C. agg. Ibs. 3 _ Location, erer AME Touch A/S BRT Sieig Sand Ibs. _ Cone 12-78 Reo OEtt, Pert d FELL Water Zags Admixture a Other ~ Air Ent. (oz/cwt.) = Remarks} “4gevec PUD ge Buecker AND PAG Water Added on Job 2 3 Samra @ Berra Cente Ar MEO Tek ivsig (gals.) | 3 | £56 Field Test Methods Please refer to Field Report No. elt Mia astucta3[__ | astmcise[ | ASTM C1064 ASTM C173 [ ] et ———-— wn Inspector | AE wna astucai/~ | other |_| Laboratory Data Design Strength | ex @ 28 days Date Specimens Rec'd. Cyl. Test ‘Field Max Comp. Tested Break Laborator ; : y Code Date Cure Age Dim. Area CF. Load Str, (psi) _Set# By Type Test Method v8 || - 7 |lanexg, astucs9—s [| S-b ce || | | | astmcio9 [| Sp ze || | astTucei7 [| Bud, eff L asTuci231 [| = astmci01i9 [| = ie otter[ | LY Test Results Remarks | Loy [| _|Conforming | ae | [| Non-Conforming | ; on i Results Reviewed By | \__Date Reviewed [| Codes for Break Types: 1. Cone 2. Cone & Split 3. Cone & Shear A 4. Shear 5. Columnar (Split) | Measurement Uncertainties: ASTM C39=Cores +/- 8% FIELD REPORT NO: 117896 42KkKrazan & Associates, Inc. ENVIRONMENTAL ENGINEERING GEOTECHNICAL ENGINEERING * CONSTRUCTION TESTING AND INSPECTION puorrl6low AIPSaMirey DATE: eee CONTRACTOR: PROJECT #:__“2€ * “20s? JURISDICTION: _<77% G6 477 ZownSznd PROJECT: Jed c8as" KCNC! CARE PERMIT #: ani 0 LOCATION: “F%. Zoedn“sex vd INSPECTOR: 44 cerl Cee KRAZAN PROJECT MANAGER: __ 77% WEATHER: #77 eee 9 TEMP. “2° pA?ANI FEPRESENH Tie OAC Sim te (Eft AMT ECTICA! A Biter FACE MENT. FLW inte. KEP RESE MAU: OBGERLNSD CONTENC EK , S0E AP Ke POP EY Cates CORL Dest Ata... ContTRAAOR PORES CRON Yl _EX! STIG Ath NEG Cat tA bly, poy BAKES, Es A FURCE FB FLAN ot FPRAAE @ ME feokwc JAY , Fe RE CA TW AE Bevtentn Sr AN Were} PAE Atl Font COnice fe 7b Latics /§ (AEP RESONATOR NSAP FOR VECO FESO CAST A Er SRECHMIENG, SEG _7ES 7 Feree FOR $x2> z ee mee PASKG Cp eae e CR. tH VPO7Y, Re See Ts Equipment/Asset Number(s): To the best of my knowledge, the aboe WASY WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: we we p. Ce = This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 ' : ', : ', hi FIELD REPORT NO: 117733 42Krazan & Associates, Inc. GEOTECHNICAL: ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION pate: 4 49°/0 CONTRACTOR: Andersen _ PROJECT #; 06" (005/ JURISDICTION: @7y of fot? Tocow Sud? prosect: Leesov fed h (ate, URL Sule permite BY. _/2'D04 LOCATION: 04 JpraSen € INSPECTOR: 7m. SHUTS . KRAZAN PROJECT MANAGER: 47/2 WEATHER: fv 4/24 TEMP: GA ~ Aik2dn Inspectok on Srte_fok Cpoxy AvehoR _juspection at Ast ial bate jill pce G2 fot Kociton Ghee Show pok pace 9-Y tetarl Hy ; Hed2An Jus zoctoa ~ REVTEweL.. JLANE Ante? foUns Lf poles AT top Awe tgttom Conmtetm ta ~/a ns) YbehCaAC Location at heft Ww Aside eat 2poxswy 18 dhaditteO dye td pollowWEMu. Wal. (wewecrk ot Aecoed * Loughlin- Beter' hundow” fAdve appjove? ase of “Hollow tJ atl Aachog Sleeves , onttactt An® ALATA ) Spector die Aegyedel BET fbb Pobtat VanCe. olvGectoe. abKcaved AUC FoleS feille® Zo pits jwsteuction®, all has were CIEANEL Fa MBLl es. {Nn sheucHOon ( plow: Brus blo ws), we CARCAS oF BDL Govcdete A A~S soban “WAS PHCeD to A Adopt, of 4” LOfOTAEL bari7h AA’ Adece ate Anat at Synpsor! Cary 2k C6), Wr AE AS “at . Aallou) CHL rwAd€ Aollow wall eee 10OLO place) A Dp mit ne Ot 6 fw Softh @porvie® An@ then a AS bAL WAC IN map feb poke D6, di Acetic we Cxgy ZT 104d Tite Si mpson Sol OL poyy = O6°3I Il MAAN IV$ joc tdi Aeguestel tw stanIhy while cottect $/2e@ poles were AMEDD AO CfOANCO to [HE oS : In)! Equipment/Asset Number(s): i L/] * hiv fF To the best of my knowledge, the above was / WAS NOT performed in acsontance-with-the diSihoved ad eT and regulatory requirements. Superintendent/Representative: rs. Technician: / / fy AW fi. f' Mell 7 This report indiéates our inspector's observation and testing results based on the site condition-and contractor's waihcs This information is ‘subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. The information provided on this report is prepared for the exclusive use of the client. This report may not be reproduced in any format without the written permission of the client and Krazan:& Assoc. Offices Serving the Western United States ; . Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 FIELD REPORT NO: 119579 43KkKrazan & Associates, Inc. GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: “O4/2G/ 2ovo CONTRACTOR: _~avEes6oN JURISDICTION: 73 pre Sew CI790E LT PROJECT #: 4QO2- f/OOT/ PROJECT: _7 4 £<fe%,0W WHEW Awe, AI AE Sai7Z PERMIT#:_ AL Dp -svo-cos INSPECTOR: Aope £24 £2 Deel S LOCATION: J¢ ¢¢ee50u GENERAL Monogr TA KRAZAN PROJECT MANAGER: TB WEATHER: zw7ew soe TEMP: 27? AKRAZAN ZMYZECTE I? OW SITE FAR FRoxs, AN Kol ZFTNSPL CTION AT S$ 254/77 DowsF,G S0u7H OF Roo y AS DR4Aw 6 oN 5-4 Drra/eh If. 4250 Tw Contuctow wy RET oz Z DATFO 4/ PS ROA/IO 2 HMotA s Ar fff EE Zves EF LOCATION LON £2 LZ? Vi et N& TREW EY AST TAL NORTE SIDE OE EDGE DF THE Exercise DRILLED FATTO THE SHue CaZ MOO, ALL KOLES (oe ; dat 7 SLAB OX GRADE, Hoo ear TA Afra Zz 4240 bee A UF FOR? INE (3-1 ke Wet AellE CLEANEID WITTY thyeneo Dow FL S — BAaAGQENDMENT DE QE mF 4 77227, 2 Seon SET £ foxes - Ek OF RAT LOH (DATE BRU SY AND Gor 29¢S552) 4/R, 4/34 L BOM, 1495 i SEO AAG YER 1 AN CERTEARES LNSTRUCT OW 2 Bo GO MA Lf AE OY SATE A SAM BEZE OF 72992755 QA AR be CE ROUT 153 SE / TMF r4 ec LACT pete AVI? 44A4iwag , aK T4kKEw OT A Doowiww4z¢ ONE SHEET OF ¢- 227 SEE CYLINDER WEIORT £2PR%B2Q JOR Ses7 Ware CuaAG ur FREE ea s/, | j : eee j a = — Hi} iry\] {| LA ——— — i ny TIT Hil dil tt fU TAH] | - t | | Equipment/Asset Number(s): | a To the best of my knowledge, the abaewas) WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Technician: ° Superintendent/Representative: 2 ee ec KE J deg me This report indicates our inspector's observation and testing results based on the site condition and_contractor’s activities. This information is subject to review prior to final submittal By signing this report, our eport may have been provided by others on site. The information provided on this report is prepared for the exclusive use of inspector does not accept responsibility for validity of the results. Some information on this r the client. This report may not be reproduced in any format without the written permission of the client and Krazan & Assoc. Offices Serving the Western United States a Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 ==Krazan & Associates, Inc. CYLINDER REPORT NO.: 4733? GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: OF /2¢/ 2270 CONTRACTOR: AN DER S2K/ PROJECT #: Do = Sepep esl PERMITNO.: 240 so-aogy PROJECT: Ve Fee Bas eyy ALS EP PICA RE fp) ZT INSPECTOR: L02dbe Ege tA tS LOCATION: VzZerF acon Gea / me JURISDICTION: cc 47 es oR Fen oe LD a Oo KRAZAN PROJECT MANAGER: nwa WEATHER: INTER 1OR TEMP: 477 Field Data Reported Batch a Concrete | CRow 7 | Other | O Rot | Cement Type | at # Supplier | oe. WTF DY Plant No. L — | Site Mix Design Actual Mix No. Mix _ Air Unit Cem. Ibs. , Slump Temp. Temp. Wt. Time = Truck# ‘Ticket # % Air (in) (F) (F) (pcf) F. Ash lbs. Loo || | | Pe | | C. agg. Ibs. 2 Placement Area C. agg. Ibs. 3 Location Bast utsee, Door wg TNF be ra g wars ock ) Sand Ibs. Sample nD AT BIH eanRSE AX Water Admixture = Other ical aaron : rn) | al Air Ent. (oz/cwt.) Remarks PLACED P crent| sd g +e m\ it] || Water Added on Job | lI {|| 8. Hy} (gals.) MA! Ly | | | Field Test Methods Please refer to Field Report No. Lf GBD Te } ASTM C143 [| ASTM C138 = ~ DSH | astmctosa[ | astmci7s[__| r= SS Inspector |_~ 22% Du. LD | astucai |_| other[ | Laboratory Data Design Strength | 2 Q5 2 | @ 28 days Date Specimens Rec'd. [| Cyl. Test Field | Max Comp. Tested Break Laboratory Code Bate Cure Age Dm Area CF. Load Str, (psi) Set # ey. Type Test Method £3 7 ae astmcs9 [| [Shay Ee |__|] astucioo [| (BY asi|_} I ' ast™mce17 [| P | asTMCci231 [| astmcio19 [| Pa oner[ Test Results Remarks [| Conforming |] Non-Conforming L Results Reviewed By | Codes for Break Types: 1. Cone Measurement Uncertainties: ASTM C39=Cores +/- 8% 2. Cone & Spiit [KX] Date Reviewed [| 3. Cone & Shear A 4. Shear 5. Columnar (Split) | é ia 23kKrazan & Associates, Inc. FIELD REPORTNO: 119980 GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: OO ¥/253/ 20/2 CONTRACTOR: __QweER sory PROJECT #:_ 404 ~“O0CS7/ JURISDICTION: cry oF oa? Te PROJECT: teeevz2s50n He tve me Tenanl PERMIT#: 24) ~ “Cog LOCATION: 72 £<¢ E esou én Eett Howntse Vet faemcenn INSPECTOR: 4ZowZee D4ers i KRAZAN PROJECT MANAGER: TR WEATHER: Z ws DE TEMP: ~9°? A RA 2 AN _ZANSPECTOR OW SITE AOR SPEC Ae TNsyF CT Ow OF LO FIN ECROCE CIENT STEELS f. sy BAT eee F408 , FURT EC pi PRoWeé fe aT, SUE AREA OF Fé EVM Feck SL ada bw yp JF ae" REBAR elt O<, EACH ht oe OW J2 DOBIES IN CENTER OF 6"BLALH LJAPOR LUARRIEL JE yp hl EK PLACE pb 2 Lee 94L. FICE YS SFALED belly 7/71 2oT “<4 TO EXOsTNS FACES OF SA CHT CONCRETE. 442 WRAL H OM SGHEFAT S72, L of DETALEL a 3 AND DWEEL 4-2. "2 DREOWLES B22 ED ZW Me. LOL Q2¢“%o.c,. AZ 2Z£ 4 FLEES DFE Liirte GG PA swfao ZED 404250 PEN LORCEMENT OF £6 i SEINE TRENCH LAS SLAL + AAI ae EPsTo£# an A A 220 RI Reese 2F Daur ES EPOX GEL) 72 FUGE D, ba pt ZY Sa KE PAR Bee ie HE TMV AE FEILO, JO mitt LAP 2 3PRAIR TN piace, ue~JY mastic AT EDEL S a Wek SLAB REMI IS DA y Der S7I- 2 OF AppeROWF 2 LZAN 5. id — 4 Equipment/Asset Number(s): To the best of my knowledge, the above(V AS / WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Represéntative: Technician: Sa ere Ze Pa crrig sie This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 = €3Krazan & Associates, Inc. GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION CYLINDER REPORT NO.: 35345 DATE: OF 2G amore CONTRACTOR: FIV DER S 2x PROJECT #: /O@-/005/ PERMIT NO.: BLO /ODmoE¢ PROJECT: Tf AE ZAS OW Bee nee TK ENT INSPECTOR: LOLM FL EZ LAD LLL 3 LOCATION: SEXEE 2: OA BENS BRh Mfesgel Fé JURISDICTION: CSS & pF feri flows: BEKO KRAZAN PROJECT MANAGER: Th WEATHER: aL2egg TEMP: s7° Field Data Reported Batch Data Concrete | Pa | Other | aaa | Cement Type | Zz -Z | Supplier le OOK Ke p71 —aiex | Plant No. Site Mix tal Design | | Actual| Xx | Mix No. doce ‘ A c Mix Air Unit Cem. Ibs. JOd. ; ; . Slump Temp. Temp. Wt. G 3 Time — Truck# Ticket # % Air (in) (F) (ey (pcf) F. Ash lbs. — +e capes lezas|L¢s__|l +70 || | 2” erisolL— | |) cats C. agg. Ibs. 2 jee a LBS 23 Placement Area C. agg. Ibs. 3 Pu “ Se, BEEF Location S L413 fF LA Z Z 7 ENMINT 2 PYP ROVE MENT « Sand lbs. 1313.8 3 Gre gi FAAP e ral OF fA 3O oS SRO 74 CLAD, Water AS Grtseory South, CLNIE ROL 8 Fuck SLA FLOOR « Admixture| 2 e,a7> || 2/55 °% Other). Fuse 23.88 oz Air Ent. (0z/cwt.) | ase Remarks /72 ICE j? By [32079 Fem? _ __ Water Added on Job Se GA omer ae re eT go LE CHa AL VIBRATION ~ (gals.) | UD )) ETI ield Test Methods Please refer to Field Report Non 4 [72a | 1 | i] asTuc143 Ly | astuciss[ | 7 ei WT TT ~~+astretoea 4] astci73[__| Petty J Ht wert iZ | ORI ASTM C31 a, other [| Laboratory Data Design Strength Date Specimens Rec'd. [| Cyl. Test Field Ma’ Comp. Tested Break Laborator : y Code Date Cure Age Dim Area CF. Load Str, psi) Set # By Type Test Method LE | 7 Weng astucsa—[ =}. 4227 | 42 }|_| astMcio9 [| 5fa1 as |l_/ astucei7 [| x || | a : asTuci231 [_ | : | a AsTMCto19 [| Test Results soporte were, “erage, Bieriaties aeaiial [| Conforming [| Non-Conforming Results Reviewed By ~aaere + ~ Date.Reviewed [ Codes for Break Types: 1. Cone IX] 2. Cone & Split 3. Cone & Shear Al 4. Shear 5. Columnar (Split) | Measurement Uncertainties: ASTM C39=Cores +/- 8% pean Nee, we FIELD REPORT NO: 119581 42Krazan & Associates, Inc. GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION CONTRACTOR: __JUPAW DER sow JURISDICTION: cs75 of JQ RT JFow AN SEND DATE: 64 /a¢/ 20/0 PROJECT #:_4@ G-/soao0S/ PROJECT: J¢¢44£¢ 50" HEALIH CARE Te nAanT PERMIT #: 42pD- vocow LOCATION: U¢¢rexksow Geversc Hos 2TAe INSPECTOR: sow ee Daw KRAZAN PROJECT MANAGER: mL: WEATHER: CLEAR TEMP: 405 ZMAEBPECTION DF DONC KR ETEK LZ ACL ZEAL KRAZAN TaAlsPECTOLR OW SITE FOR sp&crge 27. .GAAL FLOOR ~-ZOR 47727 TmPRourn en? Ror. DAIRIAX(AiATE LY 1225 OQ COVCRETE PIULX YFOClm G55 wsAds bat 3 3S od YARNS OF Cowon NED -710% <a Patou bk st 4 ROOF 2RPEWIN Ge “PZ CENCRETE “2, ACER Ly DOOR) (Ph 1 2 Son see si2ATE LD Lis PIE AMA NICAL lL/VIGRAT ICR) »@§ CONCH EIE we LEM) PF HWATAR FE 2 ONE SET OF Y- GK" mony RECS ION TEST SALES bE ee CesT LHE. ADLTIXTARE CLEN/A 1) 7IOO WAS AEP ou RED YANNI? AIIDFOD TO FAY A2A0NAYD PM SITE, ZO aT ip ZF Setesnygs SFE Cy csv DER Reé2eRT 34395 For » TESTER For ttunp, TE54T DOATA. ei er | Equipment/Asset Number(s): To the best of my knowledge, the abo S / WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Pp Superintendent/Representative: Technician: This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. -_ Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 425 . FIELD REPORT NO: 5 43Krazan 2 associates, inc. 119585 GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: OsS/OT/20/0 CONTRACTOR: 9 WV DER sox PROJECT #:_ 4O@ - JURISDICTION: — -) Ze o£ be? Toten sen PROJECT: J £44 e2504 422 LL bo Em enwT PERMIT #: #12 LOCATION: _J£4 se 4 s50oN~N GEne eat Mes aTay INSPECTOR: LOWS Ce A4es 5 KRAZAN PROJECT MANAGER: J 1% WEATHER: 7-5 ee ey egp~ TEMP 7° KBRAZAN TNSPECT EO OY WE Fon SPECIAL ENSIECTION OF Lacx. AneHeod Geau Linen, LET AAT Seu 7’ EnNDvweec ph. EXSIGIAM & < /22t4 Ltd ee tet) TW 4A NE we f CDEP OF ANGLE “fF Dow reo THE 211erinke AQF, PS Deewuiezn ox RFT 32AGRELISION, z Gee — - 4 xv et THREAD EmMBEODED G2) Tatacnxn , 3X3 x4 ANGEL ATIEHED prin muy vt 4 ; We : OF 32 Ow cénteg THE 4EN ZT OF Roce ¢ Ly 2O, LAX ee bd S 4 4s FD. MEltf£sS <LEINED WI _ COxnpeesseE DD ze tie vVACeE ALE ANY No«vy) on 5 Baus. “1430 EYOxg GROK7 ANtho8 LYE IECTHON OF» STEEL 4INTER THAT wAS Cay ZV 70 Exogs7in & YT BAL R ee 4D Babe? 7 WIEST west Dook latiP D , AS DRAWN OW Soo 13 DETAIL » Motlgue KA 6 Aaplacs7ro OF _ /“ Khoze S, wese cLLANED wit AR AND BRuUsSKy SS eRENE GD £r2t eo we 97H LET p~prlg AO F POX . 08%, WAS USED AS BP LAE 2 Sores Doge Fo x46 GAPS OF THE SAW Cake WHERE LINTEL REsTEQ ©” En Eazchr/ 5/1BE OF DoORum 4a, 4250 Expansion AnctoR TNspECTrow AZ NEw Kite w42e FO Kot Lack os As DRAWN OW SHZET _S-F, peri & 3 2g Wt1é7T EX jlansion (JLT SG) Wp7H 47 om - L6G OW CEMER wT 9 Min, Er: BEouert? DEPTH OF & “AM ehE WERE OE SET 43 LR bee 08 FOR APIACNH IMENT ON £4ACXY SIDE OF NEte Cyne WAEC w~ a) Equipment/Asset Number(s): To the best of my knowledge, the abov WAS/ WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: - - etic “Technician: ; This report indicates our inspector's observation and testing results based on the site condition: and contractor's activities. This information is subject:to-review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. The itiformation 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 23K razan «associates. inc. rm GEOTECHNICAL ENGINEERING © ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING & INSPECTION April 28, 2010 KA Project No.: 106-10051 Building Permit No.: BLD10-004 = Ms. Dana Michelson Jefferson Healthcare 834 Sheridan Avenue Port Townsend, WA 98368 - RE: — Jefferson Healthcare Tenant Improvement MRI Port Townsend, WA Dear Ms. Michelson: In accordance with your request and authorization, the following test data are presented on the following reports, which are enclosed: April 6, 2010 Cylinder Report No. 49091 — 7 Day Break Cylinder Report No. 49089 - 7 Day Break April 7, 2010 Field Report No. 119973 Cylinder Report No. 48982 — 7 Day Break April 8, 2010 Field Report No. 117896 Cylinder Report No. 49074 — 7 Day Break April 23, 2010 Field Report No. 117733 Referenced concrete reports and compressive strength data will be mailed following 28-day tests, if applicable. If you have any questions, or if we can be of further assistance, please do not hesitate to contact our office. Respectfully submitted, EZ _— & C V © TS Penn Seely, Laboratory Manager Ht . Peninsula Division me 7 | PS: md Enclosures CC: City of Port Townsend — Fred Slota With Offices Serving The Western United States 1230 Finn Hill Rd NW Ste. A ¢ Poulsbo, Washington 98370 (360) 598-2126 © Fax: (360) 598-2127 Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-100051 Weather PT. CLOUDY Jurisdiction CITY OF PT. TOWNSEND Cyl.Code P17630 4/6/2010 Report No. 49091 Permit No. BLD 10-004 Pour Date Project JEFFERSON HEALTH CARE Engineer Location PT. TOWNSEND Architect Client JEFFERSON HEALTH CARE Contractor ANDERSON Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. Site Mix X Design Actual Initial Weights Weights Flow or Grout Air = Max/Min MixNo. DESIGN MIX Slump Temp. Temp. Temp. Cem. Ibs. 160 Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. - 11:25 = = a FLUID 62 62 - C. agg. Ibs. 1 - C. agg. Ibs. 2 - Grout Box Used C. agg. Ibs. 3 - Number of units used to form specimens Sand Ibs. - Water Ibs. 6gal Placement Area Air Ent. (oz) - Location CMU WALL MRI SUITE 0-24" FROM SLAB Other (oz) - Other (oz) - Other (oz) - Other (0z) - Water Added on Job (gals.) Field Test Methods Remarks MIXED ON SITE PER MFG SPECS X ASTMC143 ASTM C138 X ASTM C1064 ASTM C173 X ASTMC31 X ASTMC780 OTHER Inspector KAMERON BINNS we Laboratory Data Design Strength 1,800 @ 28 days Date Specimens Rec'd. 4/7/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb = Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type/X ASTMC109 P17630 4/13/2010 7 2.00 4.00 0.0 3.14 6660 2,120 1 ZL 1 1X ASTMC617 P17630 5/4/2010 28 ASTM C1019 P17630 5/4/2010 28 Other P17630 H Fr . I =<] =| Test Results Remarks FR# 119424 Hl || ; Conforming Results Reviewed By wy wo Date Reviewed 4-(3-/0 Non-Conforming Codes for Break Types: 1: Cone Form 04103 Revision 0 Effective Date 12/02/02 Split Measurement Uncertainties: ASTM C109= +/- 10.7, esp 8 +/- 14.4% 2: Cone & ~ 3: Cone & Shear 4: Shear 5: Columnar (Split) The information provided on this report is prepared for the exctusive use of the client. This report may not be reproduced in any format without the written permission of the client and Krazan & Associates. Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-100051 Cyl. Code P17619 PourDate 4/6/2010 Report No. 49089 Weather PT. CLOUDY Jurisdiction CITY OF PT. TOWNSEND Permit No. 2009-4 Project JEFFERSON HEALTH CARE Engineer Location PT. TOWNSEND Architect Client JEFFERSON HEALTH CARE Contractor WINSLOW MASONRY Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. Site Mix X Design Actual Initial Weights Weights Flow or Grout Air = Max/Min MixNo. DESIGN MIX Slump Temp. Temp. Temp. Cem. Ibs. 200 Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. - T257 - - -- FLUID 63 61 - C. agg. Ibs. 1 - C. agg. Ibs. 2 = Grout Box Used C. agg. Ibs. 3 - Number of units used to form specimens Sand Ibs. - Water Ibs. 6gal Placement Area Air Ent. (oz) - Location CMU WALL MRI SUITE 0-32" FROM SLAB Other (oz) - Other (oz) - Other (oz) = Other (oz) - Water Added on Job (gals.) Field Test Methods Remarks MIXED ON SITE PER MFG SPECS X ASTMC143 ASTM C138 X ASTM C1064 ASTM C173 X ASTMC31 X ASTM C780 / OTHER Inspector KAMERON BINNS Cf Laboratory Data Design Strength 2,000 @ 28 days Date Specimens Rec'd. 4/7/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb = Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type ASTM C109 P17619 4/13/2010 7 3.00 6.00 0.0 10.82 45435 4200 4 ZL 1 |X ASTMC617 P17619 5/4/2010 28 ASTM C1019 P17619 5/4/2010 28 Tr\ecPretlwWV ef, Other P17619 H tL) Ui! [Lo | Test Results Remarks FR #119424 | | | Conforming Results Reviewed By ,. | Date Reviewed. 4-3-1 Non-Conforming Codes for Break Types: 1:Cone 2: Cone & Split _3:Cone&Shear 4° Shear 5 Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Form 04103 Revision 0 Effective Date 12/02/02 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 Krazan & Associates. z= 19972 43Krazan & Associates, Inc. FIELD REPORT NO: 329973 GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: <4—~7-70 CONTRACTOR: 47U 2K S44) PROJECT#:___ “2G -/OOS / JURISDICTION: _/OK7~_ Few SEO PROJECT. TGA Gon) HRALTY CAKE PERMIT#:_ 34D 4/4 -O0¢ LOCATION: (VOCRT TOLoOns6EY D | INSPECTOR: (47Z4 (AGEL LA? KRAZAN PROJECT MANAGER: __\#727 gl WEATHER: OC” TEMP: 7 “vy oon soa aiaseienemmnninaimres actinascasiiaaammenaaed casi snare eevee OW S/T#@ (OK KB67re40 POsPECT IO , CDOT Sih oF 6, App CEP2TUIUUOUS fu 5S PZo7vOW ye Capi Mite tyr1ELS FZ Aki CROUTE> wets wer wale. Cxeoerr LAS, BY Lnuragnk DAT HBR IILE, COAKSE CKD SV Z7Z L27/ XD), WAL B4as_44*042 By Bucvers. OVE <<Go te LIAS. DLYKGA) wo C481 1 S87- 2F 4 Cel Choer Ccl1éts LOR CAMLKRESS(2-) TESTIS. SEA CKO EASIR 2D WL SPBOLEIO LO LOKMATION, COMEOL(OMED BY ROW BE WAKA— Zor. GAROCT- ZLACED fA BR YIFTS, ABSTREL Pint) ALE" 2c. UTICA AnwrP 22° pe ee LDEIZ aro TH £4 SZ, RE67 Fe pro _BXIGTIWI GG (hte PR FE J-éE-yo TOIL. 6 Za ae UA @200F%8® 77) 2 xzveErs Equipment/Asset Number(s): CL FEIF= ‘im | To the best of my knowledge, the sons) WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Represéntative: itm O This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review fir to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc EFFECTIVE: 4/99/2009 Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-10051 Cyl. Code P17618 PourDate 4/7/2010 Report No. 48982 Weather O'CAST Jurisdiction CITY OF PORT TOWNSEND Permit No. BLD 10-004 Project JEFFERSON HEALTHCARE Engineer Location PORT TOWNSEND Architect Client JEFFERSON HEALTHCARE Contractor ANDERSON Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier MUTUAL Plant No. Site Mix X Design Actual Initial ' Weights Weights Flow or Grout Air Max/Min Mix No. = - Slump Temp. Temp. Temp. Cem. Ibs. = = Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. - a 12:20 - - - FLUID 57 48 - C. agg. Ibs. 1 - = C. agg. Ibs. 2 - - Grout Box Used X C. agg. Ibs. 3 - - Number of units used to form specimens 1 Sand Ibs. - - Water Ibs. - 7 Placement Area a Air Ent. (02) - - Location MRI WALL SECOND LIFT TN} other (oz) - - MUTUAL MATERIALS eee al =|] | Other (02) ; : DESIGN MIX, 80LB BAG. : |] other(oz, . (uu iL Other (oz) - - Water Added on Job (gals.) - ee Field Test Methods Remarks SITE MIXED; MECHANICALLY CONSOLIDATED TWICE, X ASTMC143 ASTM C138 PLACED BY BUCKET. X ASTM C1064 ASTM C173 | X ASTMC31 ~ ASTM C780 OTHER Inspector BILL UGOLINI Q Laboratory Data Design Strength 2,000 @ 28 days Date Specimens Rec'd. 4/8/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb = Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type ASTM C109 P17618 4/14/2010 7 3.25 6.00 - 10.59 46235 4,370 ZL 2 |X ASTMC617 P17618 5/5/2010 28 ASTM C1019 P17618 5/5/2010 28 Other P17618 H Test Results Remarks FR 119973 Conforming Results Reviewed By y,~ Date Reviewed y-/4-/o Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) come easurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Revision 0 Effective Date 12/02/02 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 Krazan & Associates. Saar pS an 2S FIELD REPORT NO: 71 7896 42Krazan & Associates, Inc. a GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: aaa CONTRACTOR: ___ Zu» WS tan MAsewi2y PROJECT #:__ <@6 - Ze0s¢ JURISDICTION: <7% #4 Fr untsand PROJECT: _Vetetsax! AGAIN Ones PERMIT #: Pond -Y LOCATION: “PF: FasdasexnD INSPECTOR:___A@Rea _CLubdé KRAZAN PROJECT MANAGER: __. 73 & WEATHER: #@_ eee 4 TEMP: “3° Silenzaal PEPRBSENTHATUS onl Sim Fest 1 _ NS TECT IN! Arvo Gone FRAEMBVE. <P WE Sure. TEPPESENMINTUAE OTR ERLNSD CEVA CEsIZ 22K, SAS AUX Sarre 3Y DESaw More. Con WAteR FPtAen CRETC AW ExiStivG Catt COAL C AGW PReoxinmy, Ard NEW CAtIt RIL, py BUCK. KEPREENMAE RBE2ZYGIED DWS Aevd N6zTE) BE 7A FERRE PRR. FAME Roca Peer CAG) ACL _Frtem _ Coma 72 78 oMmzsE 1S IEP RESSVONTICE ORAiykD A SRaIPUS Fer ftEth 7ST frovd CAST , Ser GS 3K%3X6" Grour srscwenwy, SEE 7ESr Reser For Rssuexs ch +H Y8O7Y, a Equipment/Asset Number(s): To the best of my knowledge, the above WAS’ WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: a ea a This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc EFFECTIVE: 4/22/2009 Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-100051 Cyl. Code P17619 PourDate 4/8/2010 Report No. 49074 Weather PT. CLOUDY Jurisdiction CITY OF PT. TOWNSEND Permit No. 2009-4 Project JEFFERSON HEALTH CARE Engineer Location PT. TOWNSEND Architect Client JEFFERSON HEALTH CARE Contractor WINSLOW MASONRY Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. Site Mix X Design Actual Initial Weights Weights Flowor Grout Air = Max/Min MixNo. DESIGN MIX Slump Temp. Temp. Temp. Cem. Ibs. 80 Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. - 11:10 = = = FLUID 54 60 - C. agg. ibs. 1 - C. agg. Ibs. 2 Grout Box Used C. agg. Ibs. 3 - Number of units used to form specimens Sand Ibs. - Water Ibs. 5gal Placement Area Air Ent. (oz) - Location CMU WALL MRI SUITE COARSE 12-15 INCLUDING Other (oz) - BOND BEAM Other (oz) - Other (0z) - Other (0z) - Water Added on Job (gals.) 5 Field Test Methods Remarks GROUT PLACED VIA BUCKET AND BAG. X ASTMC143 ASTM C138 X ASTM C1064 ASTM C173 X ASTMC31 X ASTM C780 OTHER Inspector AARON CLYDE Laboratory Data Design Strength 3,000 @ 28 days Date Specimens Rec'd. 4/9/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb = Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type ASTM C109 P17619 4/15/2010 7 3.00 6.00 0.0 10.87 41220 3,790 4. AC 4 |X ASTMC617 P17619 5/6/2010 28 it | ASTM C1019 P17619 5/6/2010 28 || ae Other P17619 H | Test Results Remarks Conforming Results Reviewed By ~ Date Reviewed y-($“/0 Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Form 04103 pnp — 12/02/02 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 Krazan & Associates FIELD REPORT NO: 7} 7732 ( i i 22Krazan & Associates, Inc. GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION pate: “f29'/0 contractor: Andasaw PROJECT #;_/06* /005/ JURISDICTION: G7y of But Towon sonV prosect: efeesov feslth(nse hl Sule permite BY. 70:204 Location:_(O& Pouagen J | INSPECTOR: mu SHuAS . KRAZAN PROJECT MANAGER: S77 = WEATHER: fv e/0L TEMP: GA~ Yeh2hn Tispectok_on site fol Gooey Apehoh_pnspectoon yt AstiJall Contee pti page S.. fot foctton Spec“ GhOOW _ por 2 §- 1. ViGN hes C2 AN Lv Spectoa ROViCWED SLANE AyD Spun oh holes At top AN® bottom conbem tO plans, Yebtiea Location pt hett aw Ri'gide et agen, /3 MadtileD due td follow EMU Wak. (wepeer af Beeord “ houghlin- Beter’ hundew’ jAve approved use of “Hollow Wall Aychog Slectes , Briteactoe And [{PAZAN ) Spector __ Adve hepuete/ B.El.. Bet Confolmanee, aluypatoe abseoveD ~lC holes LeiWeD to puke jnsthyetions, all hiles weee closed ta rity pnsthuction (plow bers blow), Sw Qsens oF SHO @ouetete AWS poles “tts pMceD to A dJogh of XY" tasotrer uth dv Adecuate Ammonent xe Simpsov Sot 22 Cpory, wn_Mhew “at follow CMU whe follow wall Anehol& wWeLe plhes) A_WIN/ Mt me ot 6% fn saofth OpoxleO AWE Then a AS LAL was pvsotee) fek Yi disect it (ONE Opitrtion Date SF mpson SetOX Epoyy = b6- 3" Il LRA2AN [Wspectae- _ begueste? stant by while eoetet size holes 1 )eKe Bhllel AO cleaned tp (U6 HER CEe Equipment/Asset Number(s): FER BE To the best of my knowledge, the above WAS / NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: g Loy This report indicates our inspector's observation and testing results based-on the site condition and contractor's a ek This information é is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been proviégd by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 EFFECTIVE: 4/22/2009 DAILY FIELD REPORT 2009.doc 42Krazan & ASSOCIATES, INC. GEOTECHNICAL ENGINEERING e ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING & INSPECTION April 28, 2010 KA Project No.: 106-10051 Building Permit No.: BLD10-004 Ms. Dana Michelson Jefferson Healthcare 834 Sheridan Avenue Port Townsend, WA 98368 RE: Jefferson Healthcare Tenant Improvement MRI Port Townsend, WA Dear Ms. Michelson: In accordance with your request and authorization, the following test data are presented on the following reports, which are enclosed: April 6, 2010 Cylinder Report No. 49091 —7 Day Break Cylinder Report No. 49089 — 7 Day Break April 7, 2010 Field Report No. 119973 Cylinder Report No. 48982 — 7 Day Break April 8, 2010 Field Report No. 117896 Cylinder Report No. 49074 — 7 Day Break April 23, 2010 Field Report No. 117733 Referenced concrete reports and compressive strength data will be mailed following 28-day tests, if applicable. If you have any questions, or if we can be of further assistance, please do not hesitate to contact our office. Respectfully submitted, T = | Se ieee =< Penn Seely, Laboratory Manager Peninsula Division PS: md Enclosures cc: City of Port Townsend — Fred Slota With Offices Serving The Western United States 1230 Finn Hill Rd NW Ste. A e Poulsbo, Washington 98370 © (360) 598-2126 © Fax: (360) 598-2127 Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-100051 Cyl.Code P17630 PourDate 4/6/2010 Report No. 49091 Weather PT. CLOUDY Jurisdiction CITY OF PT. TOWNSEND Permit No. BLD 10-004 Project JEFFERSON HEALTH CARE Engineer Location PT. TOWNSEND Architect Client JEFFERSON HEALTH CARE Contractor ANDERSON Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. Site Mix X Design Actual Initial Weights Weights Flowor Grout Air Max/Min MixNo. DESIGN MIX Slump Temp. Temp. Temp. Cem. Ibs. 160 Time Truck# Ticket # %Air —_(in.) (F) (F) (F) F. Ash Ibs. - 7 11:25 = = a FLUID 62 62 - C. agg. Ibs. 1 - C. agg. Ibs. 2 - Grout Box Used C. agg. Ibs. 3 - Number of units used to form specimens Sand Ibs. - Water Ibs. 6gal Placement Area Air Ent. (0z) - Location CMU WALL MRI SUITE 0-24" FROM SLAB Other (02) - Other (0z) - Other (02) - Other (02) - Water Added on Job (gals.) Field Test Methods Remarks MIXED ON SITE PER MFG SPECS X ASTMC143 ASTM C138 X ASTM C1064 ASTM C173 X ASTMC31 X ASTM C780 OTHER Inspector KAMERON BINNS w . Laboratory Data Design Strength 1,800 @ 28 days Date Specimens Rec'd. 4/7/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb = Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type|X ASTMC109 P17630 4/13/2010 7 2.00 4.00 0.0 3.14 6660 2,120 1 ZL 1 |X ASTMC617 — P17630 5/4/2010 28 aan ee - ASTM C1019 P17630 5/4/2010 28 , HD) finy Other P17630 H ino! - Test Results Remarks FR #119424 } | | | Conforming Results Reviewed By yw Date Reviewed 4-f3-i¢ Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4:Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Revon Effective Date 12/02/02 . 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 Krazan & Associates. Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-100051 Weather PT. CLOUDY Project JEFFERSON HEALTH CARE Location PT. TOWNSEND Client JEFFERSON HEALTH CARE Cyl. Code P17619 Jurisdiction CITY OF PT. TOWNSEND Pour Date 4/6/2010 Report No. 49089 Permit No. 2009-4 Engineer Architect Contractor WINSLOW MASONRY Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. Site Mix X Design Actual Initial Weights Weights Flow or Grout Air = Max/Min MixNo. DESIGN MIX Slump Temp. Temp. Temp. Cem. lbs. 200 Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. - 12:57 - - -- FLUID 63 61 - C. agg. Ibs. 1 - C. agg. Ibs. 2 - Grout Box Used C. agg. Ibs. 3 - Number of units used to form specimens Sand Ibs. - Water Ibs. 6gal Placement Area Air Ent. (oz) - Location CMU WALL MRI SUITE 0-32" FROM SLAB Other (oz) - Other (oz) - Other (oz) - Other (oz) - Water Added on Job (gals.) Field Test Methods Remarks MIXED ON SITE PER MFG SPECS X ASTMC143 ASTM C138 X ASTM C1064 ASTM C173 X ASTMC31 X ASTM C780 J OTHER Inspector KAMERON BINNS g Laboratory Data Design Strength 2,000 @ 28 days Date Specimens Rec'd. 4/7/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb = Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (ibs) (psi) Set# By Type ASTM C109 P17619 4/13/2010 7 3.00 6.00 0.0 10.82 45435 4,200 1 ZL 1 |X ASTMC617 P17619 5/4/2010 28 [ ASTM C1019 P17619 5/4/2010 28 | Other P17619 H | Test Results Remarks FR #119424 Conforming Results Reviewed By ,_. Date Reviewed 4-13-t'! Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) romeasurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Revision 0 Effective Date 12/02/02 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 Krazan & Associates. FIELD REPORT NO: 119972 €3kKrazan & Associates, Inc. GEOTECHNICAL ENGINEERING °* ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: _ <4—-7-70 CONTRACTOR: _A#-7UAK 5 #0 PROJECT#:_ _“0G-/OOS/ JURISDICTION: _ OK 7~_7OtW p56 4YO PROJECTS GAR aor) HRALTY CAKE PERMIT#:__B<D 49 - OOF LOCATION: (CFT TFTOONSEY PD | INSPECTOR: —_e L4LOEALLA? KRAZAN PROJECT MANAGER: eZee) a WEATHER: TEMP: 7 A OM S1/7Tt@ FOR KG67rse4#0 (OEPECTION , CKRDUT. SAnfe. 2G, Aypop C2P2TIIULONS fs Pleéo7von fre Ler Vite byt €#2S TF ra AKG« CHOATE tuts gel whe, Cxecet HLUAE AXED, B DLAtash LDA (hh: OAK GAD XS ad PACA AStC ED 5 45, ROE (PLE cae Zz AIT DD Z 4, YA) FS, 2: L_- “ZZ OE O) yA “RE CDmERESEIo~) TEETISLa. <eeZ Aaa gee o. Be FBOLEIO JPR FOKMATIO™: CONSO0L(OKTEO BY Dow BE WAKA Sor, ChOtrr~ f$4ACER lA BX LIFTS» AGSTREL Pisctg) ASC" 0c. URINAL Awe Za” ac Fee MlOEAZ pr THE LER _ SL REG TAZ prea oBxier e tate PR FE d-E-/o TOrmk 6 64° 0c WALL Geotgt® 4 RR AIETS OR _FEIF= Equipment/Asset Number(s): To the best of my knowledge, the wore) WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician) 0 p _ This report indicates our inspectors observation and testing results based on the site condition and contractor's activities. This information is subject to review, to final submittal. By signing this report, out inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. The information palincnennieerninemnnt ge te tah ta the client. This report may not be reproduced in any format without the written permission of the client and Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 FEFECTIVE- aornna DAILY FIELD REPORT 2009.doc Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO’ 8370, (360) 598 2126 Project No. 106-10051 Weather O'CAST Cyl. Code P17618 Pour Date Jurisdiction CITY OF PORT TOWNSEND 4/7/2010 Permit No. BLD 10-004 Report No. 48982 Project JEFFERSON HEALTHCARE Engineer Location PORT TOWNSEND Architect Client JEFFERSON HEALTHCARE Contractor ANDERSON Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier MUTUAL Plant No. Site Mix X Design Actual Initial Weights Weights Flow or Grout Air Max/Min Mix No. = - Slump Temp. Temp. Temp. Cem. Ibs. = - Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. - - 12:20 - - ~ FLUID 57 48 - C. agg. Ibs. 1 - - C. agg. Ibs. 2 I - Grout Box Used X C. agg. Ibs. 3 7 - Number of units used to form specimens 1 Sand Ibs. - - Water Ibs. $ = Placement Area Air Ent. (02) - - Location MRI WALL SECOND LIFT Other (0z) - - MUTUAL MATERIALS COARSE GROUT Other (oz) - - DESIGN MIX, 80LB BAG. Other (0z) - - Other (0z) - - Water Added on Job (gals.) - Field Test Methods Remarks SITE MIXED; MECHANICALLY CONSOLIDATED TWICE, X ASTMC143 ASTM C138 PLACED BY BUCKET. X ASTM C1064 ASTM C173 . X ASTMC31 ASTM C780 OTHER inspector BILL UGOLINI Q Laboratory Data Design Strength 2,000 @ 28 days Date Specimens Rec'd. 4/8/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb ~ Area ~~~-Load--Strength _ Tested Break|X ASTM C39 Code Date Age (in) —(in)._—=(%),-- (sa.in) (Ibs) (psi) Set# By Type} ASTM C109 pi7618 4/14/2010 7 325 600 | /-)\ 1059 46235 4,370 zL2._:«(X astmce17 P17618 5/5/2010 28 U u LU} ASTM C1019 P17618 5/5/2010 28 = Other P17618 H CITY OF PORT TOWNSEND Test Results Remarks FR 119973 Conforming Results Reviewed By be Date Reviewed 4-/4¢-le Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% F 04103 Revson 0 Effective Date 12/02/02 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 Krazan & Associates. FIELD REPORT NO: 71717896 @kKrazan & Associates, Inc. 117896 GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: tii CONTRACTOR: ZS tow MAscrwity PROJECT #:___ <6 - aos JURISDICTION: 27% 4 7 Dantes LOCATION: _“P°7. FasavsexreD , INSPECTOR: Aiicew/ Ceuve KRAZAN PROJECT MANAGER: ____ 73 S WEATHER: #27 C@e<ed4 TEMP: “2° Mlehenal “PSPRESENATUS on! Sie feat 1/1 AN6TECTicn! Arvo Glare CRAEMENE. <P AWE Sure. EEPPESEQMIATINE OB5SRLAGD CoA PR, SUS PUR SeaPPLp 134 DeEsaw Mir. ConRATOR Fetcan Gert 4 Existing, Cnty CUAL CC NGW Peoxrudy, Atl) NEW Catt Rei, yy BUT, PEPRECMMTAE RE2IBIED RNS Awd Nie) BS 7A FASE Ree Fok. Gio Pract C AGW ZL Corr Conese (2 To Conese 1S (LET RESSVONTINE ORR iYED A SRORPUS POR f(Gbs FEsr fred CAST (Ser SS 3X3X6“" Grout smscweny, SES 7E8r seer For swears CRA V8 O7Y. Equipment/Asset Number(s): To the best of my knowledge, the above WAS, WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. ' Superintendent/Representative: Technician: Ce AZ This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. The information pravided 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 Krazan & Assoc. . Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc FFEECTIVE. 49/0NNa Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-100051 Cyl.Code P17619 Pour Date Weather PT. CLOUDY Jurisdiction CITY OF PT. TOWNSEND Project JEFFERSON HEALTH CARE Location PT. TOWNSEND Client JEFFERSON HEALTH CARE Engineer Architect 4/8/2010 Contractor WINSLOW MASONRY Report No. 49074 Permit No. 2009-4 Field Data MORTAR/GROUT REPORT Supplier DESIGN MIX Plant No. Site Mix X Initial Flow or Grout Air Max/Min Slump Temp. Temp. Temp. Time Truck# Ticket # % Air (in.) (F) (F) (F) 11:10 - - - FLUID 54 60 - Grout Box Used Number of units used to form specimens Placement Area Location CMU WALL MRI SUITE COARSE 42-15 INCLUDING BOND BEAM ID) Remarks GROUT PLACED VIA BU Reported Batch Data Design Actual Weights Weights MixNo. DESIGN MIX Cem. Ibs. 80 F. Ash Ibs. 7 C. agg. Ibs. 1 = C. agg. Ibs. 2 C. agg. Ibs. 3 ad Sand Ibs. - Water Ibs. 5gal Air Ent. (oz) - Other (oz) - Other (oz) - Other (oz) - Other (oz) - Water Added on Job (gals.) 5 Field Test Methods X ASTM C143 ASTM C138 X ASTM C1064 ASTM C173 X ASTMC31 X ASTM C780 OTHER Inspector AARON CLYDE ot Laboratory Data Design Strength 3,000 @ 28 days Date Specimens Rec'd. 4/9/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) — (Ibs) (psi) Set# By Type} ASTMC109 P17619 4/15/2010 7 3.00 6.00 0.0 10.87 41220 3,790 1 AC 4 |X ASTMC617 P17619 5/6/2010 28 ASTM C1019 P17619 5/6/2010 28 Other P17619 H Test Results Remarks Conforming Results Reviewed By 4 Date Reviewed 4-18 /0 Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) com “easurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Revision 0 Effective Date 12/02/02 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 Krazan & Associates. a FIELD REPORT NO: 11/732 @2krazan & Associates, Inc. “ees GEOTECHNICAL ENGINEERING ° ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION pate: “23: /2 contractor: _AWdagen - PROJECT #:_/06* /005/ JURISDICTION: Qty of fae? peon Sond proJect: ¢eesov fdlh (gse Uhl Suilé— permir#-: Bib. £0:20% Sim Shuts LocaTion:_ 04 Powwgen J | INSPECTOR: ; * KRAZAN PROJECT MANAGER: _SA7/ Q WEATHER: fy 4/24 TEMP: GB RAZAN [Nepectk. On Site FOb Chomy Awehce. inSpection At Cast tall, Contée ynfill page S.A. foe hocaton Shee Gow pot Yiebzan J/uspoctoa Reviewed plAN& Au found poles 4F- top Aw bettom Comém to plans, Yobteal Location pt het pn ki side et agen?ny 13 MacdifieO duo td followGMu Wal. Nioweer af feeoed “ houghlin- Peter’ handon” fdve Apppoved Ase oF “Hollow Jak Aychog Slectes , rtenctoe An TRAZAW )uspectsr have hegeestel B.ET. Be Cowf0 tance. Gpacloe. obsepveD AUC foles ALtiNeO Lo tke msthuctiocs, all eS were cloaieD ta wfy [nN Sthuction (pow bras blow), Sw AREAS oF SD Qouctele a #5 poles “4S pMeeD to A Soph oF 4’ Loner witk gn pdecusle Amount xt SSimgsow Sot 22 Cpoxy, in_ heat ‘at _follew CMU wale follow wall pnehongs WeELE placa.) AWN mm ot 6" jn doffh efforleD Ank Then aAF but was svete) pok 6, dihectione Cig tation Date Simpson SeCOLEqory = 06-3/l-l HeK2an |wspectoe hequeste stant by while entted $122 oles _1,ere PMMLD And cReANed tp (HE MH EUCT (OME TA beast J} Equipment/Asset Number(s): K Badin = ——— To the best of my knowledge, the above WAS / BES, performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: <_— Q LMog , This report indicates our inspector's observation and testing results basedron the site condition and contractor's acjp {This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been by others on site. 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 Krazan & Assoc. Offices Serving the Western United States . Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 EFFECTIVE: 4/22/2009 DAILY FIELD REPORT 2009.doc Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-100051 Cyl.Code P17619 PourDate 4/6/2010 Report No. 49089 Weather PT. CLOUDY Jurisdiction CITY OF PT. TOWNSEND Permit No. 2009-4 Project JEFFERSON HEALTH CARE Engineer Location PT. TOWNSEND Architect Client JEFFERSON HEALTH CARE Contractor WINSLOW MASONRY Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. Site Mix X Design Actual Initial Weights Weights Flow or Grout Air Max/Min Mix No. DESIGN MIX Slump Temp. Temp. Temp. Cem. Ibs. 200 Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. - 12:57 - = - FLUID 63 61 - C. agg. Ibs. 1 - C. agg. Ibs. 2 7 Grout Box Used YES C. agg. Ibs. 3 - Number of units used to form specimens 1 Sand Ibs. - Water Ibs. 6gal Placement Area Air Ent. (oz) - Location CMU WALL MRI SUITE 0-32" FROM SLAB Other (oz) - Other (oz) 7 — . Other (oz) - .) \ } Other (oz) = LY —— nsf '| Water Added on Job (gals.) Ws Field Test Methods Remarks MIXED ON SITE PER MFG SPECS ‘| xX ASTMC143 ASTM C138 j xX ASTM C1064 ASTM C173 X ASTMC31 X ASTM C780 OTHER inspector KAMERON BINNS Laboratory Data Design Strength 2,000 @ 28 days Date Specimens Rec'd. 4/7/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb = Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type ASTM C109 P17619 4/13/2010 7 3.00 6.00 0.0 10.82 45435 4,200 1 ZL 1 |X ASTMC617 P17619 5/4/2010 28 =3.00 6.00 0.0 10.69 55500 5,190 1 ZL 1 ASTM C1019 P17619 5/4/2010 28 3.00 6.00 0.0 10.69 57010 5,330 1 ZL 3 Other P17619 H 3.00 6.00 0.0 10.69 56255 5,260 1 ZL 3 Test Results Remarks FR #119424 X Conforming Results Reviewed By wy Date Reviewed Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) rem oasurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Revision 0 Effective Date 12/02/02 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 Krazan & Associates. Krazan & Associates, Inc. 4230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-10051 Cyl.Code P17730 PourDate 4/6/2010 Report No. 49090 Weather INTERIOR Jurisdiction CITY OF PORT TOWNSEND Permit No. BLD 10-004 Project JEFFERSON HEALTH CARE Engineer Location PORT TOWNSEND Architect client JEFFERSON HEALTH CARE Contractor ANDERSON MASONRY PRISM REPORT Reported Batch Data Types Preconstruction Prisms Construction X Grout Supplier DESIGN MIX Solid Unit Prism Hollow Unit Plant No Site Mix X Hollow Unit Prism Grouted Hollow Unit X Time 1:10 Grouted Hollow Unit Prism Grouted Mulit-Wythe Prism Truck No. = Ticket No. - General Information Stump (in) 11" Number of Bed Joints 1 Mortar Supplier Site Mix X Mix Temp (F) 63 Number of Masonry Units Used 2 Mortar Type Air Temp (F) 61 Date Constructed Masonry Unit Supplier Design Weight Max/Min Temperture (1st 48 hrs) Masonry Unit Dimension 8X16 Mix No. PRO GRADE Cem. Ibs. - 200 Placement Area inspector KAMERON BINNS F. Ash Ibs. = = Location CMU WALL @ MRI ROOM: 0-32" LIFT FROM SLAB C. Agg. Ibs. - - Sand Ibs. = = Water Ibs. - 6 gal Admix. (0z) - = Remarks MIXED ON SITE PER MFG SPECS Water Added on Job (gals.) - Compression Testing Information Field Test Methods Diameter of Spherical Seat 9 Compression Machine Xx X ASTMC143 ASTM C173 Upper Bearing Plate Thickness 2 Calibration Date 9/9/2009 X ASTM C1064 ASTM C138 Lower Bearing Plate Thickness 1 xX ASTMC31 Other Laboratory Data Design Strength 1,500 @ 28 days Date Specimens Rec'd. 4/7/2010 Cyl. Test Width Height Length Net Max. Comp. HIT Corr. Break Code Date Age (in) (in) (in) Area Load Str. (psi) Ratio C.F. (psi) Type P17730 5/4/2010 28 8 16 8 58.29 204650 3510 3510 3 P17730 5/4/2010 28 8 16 8 58.29 191770 3280 3280 3 P17730 5/4/2010 28 8 16 8 58:29 219860 3770 —— 3770 3 P17730 | \ Ir\\| 7 P1730 HI TH HI Phy Wd ~~} | | ~ | | ms Sample 1 Sample 2 / ‘Sample 3 Be Sample 4 Sample 5 Lab Test Method 1: ASTMC1314 X —-2:ASTMC109 X= 3: ASTMC617 X__— 4: Other X X Conforming Results Reviewed By p< Date Reviewed Non-Conforming Types 14: Conical 2: Cone & Split 3: Cone & Shear 4: Tension 5: Semi Conical 6: Shear 7: Face Shell Seperation com amare Uncertainties: Revision 0 Effective Date 12/02/02 ‘The information provided on this report is prepared for the exctusive use of the client. This report may not be reproduced in any format without the written permission of the client and Krazan & Associates. Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Cyl. Code P17630 Pour Date Jurisdiction CITY OF PT. TOWNSEND Project No. 106-100051 Weather PT. CLOUDY 4/6/2010 Report No. 49091 Permit No. BLD 10-004 Project JEFFERSON HEALTH CARE Engineer Location PT. TOWNSEND Architect Client JEFFERSON HEALTH CARE Contractor ANDERSON Field Data MORTAR/GROUT REPORT Reported Batch Data - Supplier DESIGN MIX Plant No. Site Mix X Design Actual Initial Weights Weights Flowor Grout Air Max/Min MixNo. DESIGN MIX _ Slump Temp. Temp. Temp. Cem. Ibs. 160 Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. - - 11:25 - = - FLUID 62 62 - C. agg. Ibs. 1 - C. agg. Ibs. 2 = Grout Box Used C. agg. Ibs. 3 - Number of units used to form specimens Sand Ibs. - Water Ibs. 6gal Placement Area Air Ent. (oz) - Location CMU WALL MRI SUITE 0-24" FROM SLAB Other (oz) - Other (oz) = tT Other (oz) - | | ; | Other (oz) - | ~\\| | Water Added on Job (gals.) | i | Field Test Methods Remarks MIXED ON SITE PER wre dpecs jt | X ASTMC143 —— ASTMC138 X ASTM C1064 ASTM C173 7 ——— X ASTMC31 X ASTM C780 OTHER Inspector KAMERON BINNS Laboratory Data Design Strength 1,800 @ 28 days Date Specimens Rec'd. 4/7/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type X ASTM C109 P17630 4/13/2010 7 2.00 4.00 0.0 3.14 6660 2,120 1 ZL 1 |X ASTMC617 ” P17630 5/4/2010 28 2.00 4.00 0.0 3.14 8595 =. 2,740 1 ZL 4 ASTM C1019 P17630 5/4/2010 28 2.00 4.00 0.0 3.14 7870 =. 2,510 1 ZL 4 Other P17630 H 2.00 4.00 0.0 3.14 7230 2,620 1 ZL 4 Test Results Remarks FR #119424 X Conforming Results Reviewed By \<~ Date Reviewed Non-Conforming Codes for Break Types: 1, Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Form 04103 ae leis 1202/02 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 Krazan & Associates. IELD REPORT NO: 1719579 4@2Krazan & Associates, Inc. GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: QAS/ ‘2 ELADLIO CONTRACTOR: _AAVDGERSON PROJECT#:___ 0G - soos JURISDICTION: __ 3+—70 See c/7¥0E 2 T _ PROJECT:_Teree0esow Hea ane, MAE SuTe PERMITH# 2 LD = /a-20% LOCATION: EneehL. INSPECTOR:_ Aone £2 2 Dour S KRAZAN PROJECT MANAGER: TB G- WEATHER: zy ree soe TEMP: 24>? GLAD an Ane y pesareaios: WG dF uns ween tank Rene 4 Dewees ,»LmGasamewl D6 el of Gaited. a 4be Mate CARA EI taii7 tow ii Equipment/Asset Number(s): To the best of my knowledge, the abo WAS) WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our~ inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc EFFECTIVE: 4/22/2009 Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-10051 Weather O'CAST Cyl.Code P17706 Pour Date Jurisdiction CITY OF PORT TOWNSEND 4/26/2010 Report No. 47332 Permit No. BLD 10-004 Project JEFFERSON HEALTHCARE MRI Engineer Location JEFFERSON GENERAL HOSPITAL Architect client JEFFERSON HEALTHCARE Contractor ANDERSON Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. - Site Mix X Design Actual Initial Weights Weights Flow or Grout Air Max/Min Mix No. - - Slump Temp. Temp. Temp. Cem. ibs. - = Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. = = 1:00 - i - FLUID 70 67 - C. agg. Ibs. 1 - - C. agg. Ibs. 2 = - Grout Box Used - C. agg. Ibs. 3 - - Number of units used to form specimens 4 Sand Ibs. - - Water Ibs. = = Placement Area Air Ent. (0z) - - Location EAST WALL: DOORWAY INFILL (8" BLOCK) Other (oz) = 7 SAMPLED AT 8TH COURSE UP. Other (oz) - - REINFORCEMENT CONFORMS. Other (02) - = Other (oz) - - Water Added on Job (gals.) - Field Test Methods Remarks PLACED BY BUCKET; CONSOLIDATED BY HAND. X ASTMC143 ASTM C138 X ASTM C1064 ASTM C173 X ASTMC31 ASTM C780 OTHER Inspector LOWELL DAVIS Laboratory Data Design Strength 2,000 @ 28 days Date Specimens Rec'd. 4/27/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb = Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) __-(%)——(sq-iny (Ibs) (psi) | Set# By Type} ASTMC109 P17706 5/3/2010 7 200 200 | \; ~~ 4.00 12320 3,080 | Zi. 1 ASTM C617 P17706 5/24/2010 28 \| 1} X ASTM C1019 P17706 5/24/2010 28 - | Other P17706 H 4 | - —— Test Results Remarks FR 119579 Conforming Results Reviewed By je ; Date Reviewed $-3-, Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Form 04103 baoae aeons 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 Krazan & Associates. PP ae FIELD REPORTNO: 11958) €2Krazan & Associates, Inc. 119580 GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE:__ 0 ¥/23/ 2o/0 CONTRACTOR: _@v02ee2s ort PROJECT #:_/0G-/OOS7 JURISDICTION: 7% o£ Moat Ta PROJECT: PERMIT #:___ B4D - 20 ge LOCATION: 24 cere nsav woven Hosoilal Iet Gownseno INSPECTOR: 4 our eee 2derl.s KRAZAN PROJECT MANAGER: Th yf WEATHER: Zws DE TEMP: 44° Equipment/Asset Number(s): To the best of my knowledge, the above WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 MALY DIC! MN OCONOT 9NnNd Ann FEFECTIVE- 4/99/90na FIELD REPORT NO: 119587 @Krazan : Associates, Inc. (19581 GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE:__ 6 ¥ /a?/ 20/0 CONTRACTOR: _.IWDER sow PROJECT #:_ 40 G@—/oO057/ JURISDICTION: _¢/7% oF SeRT Zo wn sEWO PROJECT: _Weeee0eson Heserucene TenAaur PERMIT #:_ 62 D~ somogy LOCATION: _D¢ss2e8son @eweese Mo spite . INSPECTOR: sow F424 O4isI_$ KRAZAN PROJECT MANAGER: T8 qf WEATHER: CLEAR. TEMP: 4205 HOM SITE, 70 OpTi mi2é Sime SEE Cy tinneR ReeeRT 3 S375 FOR TEST DATA. Equipment/Asset Number(s): To the best of my knowledge, the abov€ WASY WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: Stor cl ADa ze This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 writien permission of the client and Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAI Y FIELD REPORT 2009.doc EFFECTIVE: 4/22/2009 Andersen Construction Company TRANSMITTAL 228 South Mead Street oo Seattle WA:98108 No. 10-SP003-0037 PROJECT: Jefferson Healthcare Tenant Improvement DATE: 04/26/2010 TQ: Coates Design, Inc. RE: 03300-Conerete Mix Design 710.John Nelson Lane Bainbridge Island WA 98110 “ACTION TAKEN: Your Usé . + Approved as Noted - Prints As ‘Requested ps Returried Afi Loan ~ Samples . A Retummed v, Other: Product Data Due Date: _ Other: Line Item Package Code Rev. Qty Date Description caw, Status 1 Submittal 03300-0{ 03300 04/28/2010. Conerete-Mix.Design Open oo ATE: tof ACCO.JOB 7. kee _ SUBMITTAL #_633Q) —o / REMARKS: j | | L . ___} ce: ——<—< Signed: Jamie Puracal Mix Design Report COTTON REDIMIX P.O, Box 179 121 PROMWELL RD. PORT HADLOCK; WA 98339 USA 800-732-5683 seeMIX Hl Mix Report 4000 psi 6.5 sack-6.6:sack com. [1] Strength Compressive: 4000 psi 04/23/2010 | [Compressive Strength - [4000 psi at 28 Days _ | [Source of Concrete . Aggregate size : Construction type : Ait: 00 0.0% ) Placement ; Water/Cement ratio: 0.450 {Unit Weight; 144.97 pcf jSump: 0,00 0,00 in (Design Date. 07/11/2008 Constituents : . Quantity Density Volume CEM02 - ABC Type W/ll Cement (ASH GROVE GEMENT) 611 lb} 3,150) 3.108 WATO1 =< City Water (City Water supply) 27516 1,000) 4.407 CA1 - ASTM-G-33 #57 Stone (PLANT 1). 1629 Ib} 2.690! 9.705 FAi - ASTM C-33 Concrete Sand (PLANT 1) 1246 lb} 2.660} 7.507 PEA -Pea-gravel (PLANT 1) 151 Ibi 2.700} 0.896. WR =POLYHEED 997 (BASF ADMIXTURES INC) 21.00 floz {US)yd 1.100) 0.022 Air §.0 %. ' 4.350) | | } . | Total | 301 26.995 +Remarks ; ; if additional.siump is required at jab site we-can have BASF Master Builders Glenium 7500 available on site. REVIEWED AND FOR DESIGN INTENT ONLY po cept yy Reported by DENNIS MORGAN Approval by : —s Date: 02/22/2010 Date : tf noBcerTENs HEN Ya” _ oO 04/23/2010 COMMENTSATACED = REVISESRESUBMT =] BY pare 4/26/2010 COUGHLIN PORTER LUNDEEN, INC. Consulting Engineers Seattle, Washington 98101 ). , 4000 psi-6.5 sack-6.5 sack com [1] 4000 psi Concrete Mixture Submittal Mix Design Report Design'summary Water Design % Reduction: 6.0 Manual Entry Method DRUW / FA: 0.00 pef FA Density: 0.00 ‘péf Quanitily. 275 Ib Cement Design Number of tests: 0 Manual Entry Method Cement Efficiency: 0,00 psi/ib Standard Deviation: 0 Prob. low test. 1 in: 760 Water/Cement Ratio: 0:450 Ibs/ib Quantity: 641 Ib Mineral Additive Design ‘Matefial name. Replacement Method Ratio Quantity % . Coarse Aggregate Design Work Adj. Factor: 36.2 Manual Entry Method Percent Mortar: 56.4 = Total Fine Modulus: 5.14 CA Fine Madulus: 6.89 | Coarse DRUW 98.00 i) Quantity. 1629 ib | LJ Ld Total. Aga. %: 98.00 | | MSF.: 25.300 ff Fine Aggregate Design oes ae Volume: 27.000 yd" Produce Specific Volume Fineness Modulus: 3.42 Quantity: 4397 Ib Admixture Design Material name Quantity Inc. in WIC ratio Inc. in volume WR - POLYHEED 997 (BASF 21.00 floz No Yes 04/23/2010 3 Type-A, waterreducing, and Type F. high-range water- reducing, admixtures. ‘Applications Recommended for use in- Concrete-.with varying water teduction requirements (65-40%) Concrete. where control of ‘workability and setting time is critical Concrete where high flowability, increased stability, high éarly.and ultimate Strengths, and improved durability are néeded Produetion of Rhéodynamic’ Self- Consolidating: Concrete (SGC). mixtures 4x4™ Concrete for fast- track construction Pervious Concrete mixtures D- BASF rate The Chemical Company Description AL Th RA@ sai ie ‘GLENIUM* 7500 full-range GL EN IUM 7500 water-reducing admixture ts . ; - F passed 6 reba speed Full-Range Water-Reducing Admixture ‘of polycarboxylate technology Fea é tan @ a “eatures found in-ail of the GLENIUM. ial 7000 series products. This Dosage flexibility for normal. mid-range and high-range applications technology combines state-of- Excellent early sength development peoligeaesonceadh engineering Controls. setting characteristics a meee ras tine ay Optimizes: slump retention/setting relationship specific and exceptional value Gonsistent air entrainment loall phases of the concrele . . Benefits construction process. ree | GLENIUM 7500 admixture is Foster ane of forms due to accelerated early strength development very effective in producing Reduces fmishing tabor costs-due to optimized sel times concrele: mixtures. with different Use in fast track canstruction site einen sina Minimizes’ the need for slump adjustments al the jobsite ° applica { pt : sell-consolidating concrete WERE IEE OG guriport cequloed (SCO). The-use of GLENIUM Fewer rejected loads 7500. admixture resulis in Optimizes concrete mixture costs faslet Sétting characteristics ‘cata cha as well’as improved early Performance Characteristics age compressive strength. Concrete produced with GLENIUM 7500 admixture achieves significantly higher age ca Hy. hig GLENIUM 7500 admixture early age strength than lirst generation polycarboxyiate high-range water-reduting meets. ASTM C:494/C 494M admixtures, GLENIUM 7500 admixture also-strikes the perfect balanice-between compliance requirements for workability retention and setling characteristics in order to provide efficiency in placing and fishing: conerate: The dosage flexibility of GLENIUM 7500 allows it to be.used as a normal, mid-range, and-high-range water reducer, Guidelines tor Use Dasage: GLENIUM 7500 admixture has a recommended dosage: Tange of 2-18 f oz/ewt (130-975 mL/100 kg) of cementitious materials. For most mid:io high-tange applications, dosages in the. range of 6-8. oz/ewt 25-520 mL/100 kg) wilt provide. excellent performance. For high performance and: Rheodynamic Self- Consolidating Concrete mixtures, dosages of up lo 12 fl.oz/cwt:{780-mL/100.kg):of cementitious materials ‘can bevutilized. Because of variations in concréte Materiats, jobsite concitions and/or applications, dosages outside. of the recommended farige May. be required. in-such cases, contact your local BASF Construction Chemicals representative. Mixing: GLENIUM 7508 admixture can be added wilh the.initiat:batch wateror as a delayed addition. However, optimum water reduction is geriemily obtained witha delayed addition. a | Master - ~ Builders ; Product Data: GLENIUM® 7500 Product Notes Additional information Corrosivity - Non-Chioride, Non-Corrosive: GLENIUM For additional information on GLENIUM 7500 admixture 7500 admixture will neither initiate nor promote:corrasion of | —_or. omits. se.in-develaping concrete mixtures with spécial reinforcing steel embedded in concrete, préstressing steel or —_perforniaricé characteristics, Contact your BASF Construction of. galvanizéd steel floor and.roof systems. Neither calcium Chemicals Ss copmanentative, chioride nor othér chlofitle-based ingredients are used it the au r BASF manufacture of GLENIUM 7500 admixture. ree ised aw mn Anand’ ti —< ; Paar Compatibility: GLENIUM 7560 admixture. is Compatible with tor Specialty cbricrete used fa (he reatly mix, preéast, most. admixtures used | in the production: of quaility eancrete; manufactured: concrete: products, underground, construction including normal, mid-ratige atic high-range water-reducing and paving markets throughout tie North American region. admixtures, ax-entrainers, accelerators, selarders, extended 7 p49 ‘Company's respecied Master Builders brand products. Sét contro! admixtures, corrosion inhibitors, and Shrinkage aie uséd lo improve the plating, bumping, itishing, reducers, appearance-and perlarmance characteristics of concrete. Do-not use GLENIUM: 7500 admixture with admixtures containing beta ane sulfonate, Erratic behaviors in slump, eveabilty retention and pumpability riay be LISATED-WARRANTY'NOTIGE. Wei¥airint aur tivodetts ta Be of good aunty ane wat replace or eee alana at retunc Ihe fivtruise price Ot ary prouut's proved defertwe Storage and Handling Storage Ternperature: GLENIUM 7500 admixture must be —"SeRo0Uers. SETRASE at have ci tty om seme eA ems proouet er feveweid i wMitin.ong a stored at lemperatures:above 40“F (5 °C), if GLENIUM 7500 coca torah prs etnap ls oniaent of occa admixture freezes, thaw dnd reconstitute by mechanical area: sna ad lly ezracon ht Jey savas ears ee renee agitation. “Tectrical Mahiager Shelf Life: GLENIUM 7500 admixture has.a' minimis shelf Tas fomiaties are at Kathe actor tw are base un GASES present anstege we a ee eee sl fe may be grea stal your Svar rng pena local sales répreséntative regarding suitability for use and PAOPTTS Oe aN UAE ea a a ante aaa in tal dosage recommendations if the shelf life of GLENIUM 7500 peel orogpess OF barter ives ‘admixture has been exceeded. "For Professional use only: Not for sto oor use by the general pobiid. Packaging GLENIUM 7500 admixtute is supplied in 55 gal (208 L):drums, 275 gal (1040 Ly totes and by buik-delivery. Related Documents Material Safety Data Sheets: GLENIUM 7500 admixture. ‘BASF Gonstruction Chemicals Adnixtuiré. Systems Fok awwew.masterbuilders.com (NS United States 23705: Cragrar Bootevarcl, Cleveland, Otug 44122-9594 “Tel; 860'628-0990 Fun: 716 839-821 Master { E ¥ Canada 1806 Ciark Boulevard, Brangikm, Onter LOT 4M7 Tel’ 800 387-5862 Fax. 905 792-045" Builders Yd, é-Corsinction Reséiren & Techno upgy GMBH j somes | U.BASF Corsyucton Chem.cals. 2009 Printed USA 420 LIT ¢ 2000025 Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-10051 Weather CLEAR Cyl.Code P17717 Pour Date Jurisdiction CITY OF PORT TOWNSEND 4/29/2010 Report No. 35345 Permit No. BLD 10004 Project JEFFERSON HEALTHCARE Engineer Location JEFFERSON GENERAL HOSPITAL Architect Client JEFFERSON HEALTHCARE Contractor ANDERSON Field Data CYLINDER REPORT Reported Batch Data Concrete x Other Design Actual Weights Weights Supplier COTTON Plant No. Site Mix Mix No. 40COM654 Cem. Ibs. 610 Mix Air Unit F. Ash Ibs. - Slump Temp. Temp. Wt. C. agg. tbs. 1 PEA 155 Time Truck# Ticket # % Air (in.) (F) (F) (pcf) C. agg. Ibs. 2 0.75 1625 8:35 45 470 - 8 64 50 - C. agg. Ibs. 3 = Sand Ibs. 1318 Water Ibs. 28gal Placement Area Air Ent. (oz) - Location SLAB, MRI TENANT IMPROVEMENT. SAMPLED AT Other (oz) POLY 21.6 oz 4 OF 12.5 TOTAL YARDS PLACED; SOUTH, CENTER OF Other(oz) GLEN 23.9 oz 8" THICK SLAB FLOOR. Other (oz) - Other (oz) = Water Added on Job (gals.) Field Test Methods Remarks PLACED BY BOOM PUMP; CONSOLIDATED BY X ASTMC143 ASTM C138 MECHANICAL VIBRATION. X ASTM C1064 ASTM C173 X ASTMC31 Other Inspector LOWELL DAVIS Laboratory Data Design Strength 4,000 @ 28 days Date Specimens Rec'd. 4/30/2010 Cyl. Test Field Max. Comp. Tested Break Laboratory Code Date Cure Age Dim. Area C.F. Load Str.(psi) Set# By Type} Test Methods P17717 5/6/2010 7 4x8 12.56 60430 4,810 ZL 3 |X ASTM C39 P17717 5/27/2010 28 4X8 ASTM C109 P17717 5/27/2010 28 4X8 ASTM C617 P17717 5/27/2010 28 4X8 ASTM C1231 P17717 ASTM C780 P17717 Other P17717 P17717 Test Results Remarks FR 119581 Conforming Results Reviewed By pe & Date Reviewed £ -lp- y Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3:Cone & Shear 4:Shear — 5: Columnar (Split) Measurement Uncertainties: ASTM C-39 +/- 8% enoheciy Effective Date 12/02/02 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 Krazan & Associates. eae ELD REPORT NO: Lia » & =Krazan « Associates, Inc. 119585 GEOTECHNICAL ENGINEERING *® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: O5SOF/20/0 CONTRACTOR:__AWDER sen PROJECT #:_7O@ -sans/ JURISDICTION: __ <1 Se PF /ORT Tae sen p PROJECT: DF 2t0sor RL Loko ione7? PERMIT #: BLD LOCATION: “ Ta INSPECTOR: L4owsic 14275 KRAZAN PROJECT MANAGER: TEs aif WEATHER: __ pK Ze ezne TEMP:4°7° _WWeerh EmGEODED 64 cute cnn ~ 3X3x4" zyaer ATIBCLLED pra Me a mete YR. 2 F “ON CENT 4 Mole NEO 280° os ETI ON OF ySTEEL LInTec. ral to Le ov ad (7 HerZEes , r wv) Do Ze $72 2 Y=, by. pis 2 eA, = ; wa 2 Th eer LLG RO ELOY. por, WAS 52D A5 Spottt agtas lagen TZ. z 2 “a SLE OF De2R a2, Equipment/Asset Number(s): To the best of my knowledge, the abov WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: on et CES aaie This report indicates our inspector's observation and testing results based on thesite condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc EFFECTIVE: 4/22/2009 42Krazan & ASSOCIATES, INC. GEOTECHNICAL ENGINEERING e ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING & INSPECTION May 28, 2010 KA Project No.: 106-10051 Building Permit No.: BLD10-004 Ms. Dana Michelson Jefferson Healthcare 834 Sheridan Avenue Port Townsend, WA 98368 RE: Jefferson Healthcare Tenant Improvement MRI Port Townsend, WA Dear Ms. Michelson: . In accordance with your request and authorization, the following test data are presented on the following reports, which are enclosed: April 7, 2010 Cylinder Report No. 48982 — 28 Day Break April 8, 2010 Cylinder Report No. 49074 — 28 Day Break April 26, 2010 Cylinder Report No. 47332 ~ 28 Day Break May 18, 2010 Field Report No. 120331 May 19, 2010 Field Report No. 119771 May 21, 2010 Field Report No. 119595 Referenced concrete reports and compressive strength data will be mailed following 28-day tests, if applicable. If you have any questions, or if we can be of further assistance, please do not hesitate to contact our office. Respectfully submitted, Z~ Le, > Penn Seely, Laboratory Manager Peninsula Division 1} PS: md | L— Enclosures - i cc: City of Port Townsend — Fred Slota With Offices Serving The Western United States 1230 Finn Hill Rd NW Ste. A ¢ Poulsbo, Washington 98370 ¢ (360) 598-2126 ¢ Fax: (360) 598-2127 Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-10051 Weather O'CAST Cyl.Code P17618 Jurisdiction CITY OF PORT TOWNSEND PourDate 4/7/2010 Report No. 48982 Permit No. BLD 10-004 Project JEFFERSON HEALTHCARE Engineer Location PORT TOWNSEND Architect Client JEFFERSON HEALTHCARE Contractor ANDERSON Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier MUTUAL Plant No. Site Mix X Design Actual Initial Weights Weights Flow or Grout Air Max/Min Mix No. - - Slump Temp. Temp. Temp. Cem. Ibs. - - Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. - - 12:20 - - - FLUID 57 48 - C. agg. Ibs. 1 - - C. agg. Ibs. 2 - = Grout Box Used X C. agg. Ibs. 3 - - Number of units used to form specimens 1 Sand Ibs. - - Water Ibs. - - Placement Area Air Ent. (0z) - - Location MRI WALL SECOND LIFT Other (0z) - - MUTUAL MATERIALS COURSE GROUT Other (oz) - - DESIGN MIX, 80LB BAG. i ray ( - i ] "Other (0z) - - | LY ——|| | eerie} - - I\I i | Water Added on Job (gals.) - HU : a Field Test Methods Remarks SITE MIXED; MECHANICALLY: CONSOLIDAT ED Tw nice X ASTM C143 ASTM C138 PLACED BY BUCKET. xX ASTM C1064 ASTM C173 i _ X ASTMC31 ASTM C780 OTHER inspector BILL UGOLINI Laboratory Data Design Strength 2,000 @ 28 days Date Specimens Rec'd. 4/8/2010 Cross Laboratory Mid Pt. Outof Section Max. Comp. Test Methods Cyl. Test Width Height Plumb = Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type ASTM C109 P17618 4/14/2010 7 3.25 6.00 - 10.59 46235 4,370 ZL 2 |X ASTMC617 P17618 5/5/2010 28 3.32 6.00 - 11.02 58325 5,290 Zi 3 ASTM C1019 P17618 5/5/2010 28 =. 3.32 6.00 - 11.02 60280 5,470 ZL 3 Other P17618 H 3.32 6.00 - 11.02 59300 5,380 ZL 3 Test Results Remarks FR 119973 X Conforming Results Reviewed By he Date Reviewed Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Rewson 0 Effective Date 12/0202 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 Krazan & Associates. Am Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-100051 Cy!.Code ©P17619 PourDate 4/8/2010 Report No. 49074 Weather PT. CLOUDY Jurisdiction CITY OF PT. TOWNSEND Permit No. 2009-4 Project JEFFERSON HEALTH CARE Engineer Location PT. TOWNSEND Architect Client JEFFERSON HEALTH CARE Contractor WINSLOW MASONRY Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. Site Mix X Design Actual Initial Weights Weights Flowor Grout Air Max/Min MixNo. DESIGN MIX Slump Temp. Temp. Temp. Cem. Ibs. 80 Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. - 11:10 - - -- FLUID 54 60 - C. agg. Ibs. 1 - C. agg. lbs. 2 Grout Box Used X C. agg. Ibs. 3 - Number of units used to form specimens 1 Sand Ibs. 7 Water Ibs. 3gal Placement Area Air Ent. (oz) - Location CMU WALL MRI SUITE CO Other (oz) - BOND BEAM Other (oz) - Other (oz) - Other (02) - Water Added on Job (gals.) 3 v Field Test Methods Remarks GROUT PLACED VIA BUCK BAG. X ASTMC143.—— ASTMC138 X ASTM C1064 ASTM C173 X ASTMC31 X ASTM C780 OTHER Inspector AARON CLYDE Laboratory Data Design Strength 3,000 @ 28 days Date Specimens Rec'd. 4/9/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) (Ibs) (psi) Set# By Type] ASTMC109 P17619 4/15/2010 7 3.00 6.00 0.0 10.87 41220 3,790 1 AC 4 |X ASTMC617 P17619 5/6/2010 28 = 3.00 6.00 0.0 10.96 59090 5,390 1 ZL 1 ASTM C1019 P17619 5/6/2010 28 = 3.00 6.00 0.0 10.96 59865 5,460 1 ZL 3 Other P17619 H 3.00 6.00 0.0 10.96 59480 5,430 1 ZL 3 Test Results Remarks FR 117896 X Conforming Results Reviewed By pe~ Date Reviewed Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Form 04103 ecwie Cove tarsi The information provided on this report is prepared for the exciusive use of the client. This report may not be reproduced in any format without the written permission of the client and Krazan & Associates. Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO .... 98370, (360) 598 2126 Project No. 106-10051 Cyl. Code P17706 PourDate 4/26/2010 Report No. 47332 Weather O'CAST Jurisdiction CITY OF PORT TOWNSEND Permit No. BLD 10-004 Project JEFFERSON HEALTHCARE MRI Engineer Location JEFFERSON GENERAL HOSPITAL Architect Client JEFFERSON HEALTHCARE Contractor ANDERSON Field Data MORTAR/GROUT REPORT Reported Batch Data Supplier DESIGN MIX Plant No. - Site Mix X Design Actual Initial Weights Weights Flow or Grout Air Max/Min Mix No. - - Slump Temp. Temp. Temp. Cem. Ibs. - - Time Truck# Ticket # % Air (in.) (F) (F) (F) F. Ash Ibs. si - 1:00 - - - FLUID 70 67 - C. agg. Ibs. 1 - - C. agg. Ibs. 2 = . = Grout Box Used - C. agg. Ibs. 3 - - Number of units used to form specimens 4 Sand Ibs. - - Water Ibs. - = Placement Area Air Ent. (02) - - Location EAST WALL: DOORWAY INFILL (8" BLOCK) Other (oz) - . SAMPLED AT 8TH COURSE UP. Other (oz) - - REINFORCEMENT CONFORMSrs===————CSs——s—s— Other (oz) - - ie es Other (0z) - - Water Added on Job (gals.) - ae i Field Test Methods Remarks PLACED BY BUCKET; CONSOLIDATED BY HAND. ||_ X_ ASTMC143 ASTM C138 | a | {_X ASTM C1064 ASTM C173 re X ASTMC31 ASTM C780 . OTHER Inspector LOWELL DAVIS Laboratory Data Design Strength 2,000 @ 28 days Date Specimens Rec'd. 4/27/2010 Cross Laboratory Mid Pt. Out of Section Max. Comp. Test Methods Cyl. Test Width Height Plumb = Area Load Strength Tested Break|X ASTM C39 Code Date Age (in) (in) (%) (sq.in) _(Ibs) (psi) Set# By Type} ASTMC109 P17706 5/3/2010 7 2.00 2.00 4.00 12320 3,080 ZL 1 ASTM C617 P17706 5/24/2010 28 2.00 2.00 400 17255 4,310 ZL 1 |X ASTMC1019 P17706 5/24/2010 28 2.00 2.00 4.00 16760 4,190 ZL 1 Other P17706 H 2.00 2.00 4.00 17645 4,410 ZL 1 Test Results Remarks FR 119579 X Conforming Results Reviewed By xz/ Date Reviewed Non-Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) cemteasurement Uncertainties: ASTM C109= +/- 10.7, ASTM C1019= +/- 14.4% Effective Date 12/02/02 The intormation 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 permisson of the client and Krazan & Associates ; IELD REPORT NO: J] @3krazan « Associates, Inc. [20331 GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION pate: “2- 18-1) 0 Contractor: AN decsonl PROJECT#:__1 0 6- \ OOS } JURISDICTION: (7a FL 1 OWNS eid PROJECT: “Je €FEepsonl WHeattticace. PERMIT#: —— LOCATION: SNecidenl Ave INSPECTOR: ~ o¢« (Spy dyin KRAZAN PROJECT MANAGER: ~~) wn ‘(6 WEATHER: 0 °C as & TEMP: & 2 Oy! Sete Qer Ceanves* For Specia\ SE As yecXion OF EXeansion* Aalchoc Veo ts . Contractor istaled lo 3X) and A-YS/8 xX ax Suppor Stcucuce ax MTS. ec dees 6, on SY. Contratetoc Cleaned holes ayid ‘. isdavled CxyaNnsiot aychor woltS With & widiwow SS" of 2m badwmentt sper Pier Axa Yacqud a SpeiFi cabins. Equipment/Asset Number(s): To the best of an Mowiedge the abové W WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. N Superintendent/Représentative: Ts a anata’, This report indicates our inspector's observation and testing results based on the site condition and i information is subject to review prior to final submittal. By signing this report, our on site. The information provided on this report is prepared for the exclusive use of inspector does not accept responsibility for validity of the results. Some information on this report may have been provided the client. This report may not be reproduced in any format without the written permission of the client and Krazan & Assoc. . Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360)598-2126 Puyallup (253) 939-2500 EFFECTIVE: 4/22/2009 DAILY FIELD REPORT 2009.doc @2kKrazan & Associates, Inc. FIELD REPORT NO: 119771 GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION pare: O7/9-L0 CONTRACTOR: AUD BEEB4) CAUSES >— JURISDICTION: _ 42.77 PROJECT #:_ “6-2 “/00S 1! a PROJECT: VW 2EFHES 2.) HBALTH ARE PERMIT# GAD s0O-OOF LOCATION: bX INSPECTOR: A/L2. LUG ah 12 KRAZAN PROJECT MANAGER: - W70B WEATHER: SZ) Temp: 577 & OA) S/T@ PCR WALD INI fi sfEcTIth” FoC _FleA ret We6tes On BTCA _ SWPPORT SRUCTURE + liypthné Pee ber.s™ 6 7 oF s-4¢ BY Chk PAmP oO SBY THCY Lys DEE, Cow PRs re es 21 fd WAG WEBER SHAPE HAGCAR: Equipment/Asset Number(s): To the best of my knowledge, the abo W § / WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. | Superintendent/Representative: Technician: hy \ 4 We D lop Iie mor indo or bmg cern and Sg rn aed cnc and coca actin. Ts Hrmtinm est S . By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. The information provided on this on aropnd cednr aty the client. This report may not be reproduced in any format without the written permission of the client and Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc EFFECTIVE: 4/22/2009 @2ZKrazan Associates, Inc. ELD REPORT NO: 119595 GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION pate:__o5/a//aoso CONTRACTOR:__ A WDER Savy PROJECT #:__/06-/005/ JURISDICTION: _Cp7y Oe Poor Tousn seu PROJECT: _Jee-ex Sas Heart Cane Tewaur- PERMIT #: LOCATION: — | INSPECTOR: LoweLL DALZLS KRAZAN PROJECT MANAGER: IB WEATHER: Spore y Céouzay TEMP: 50° Equipment/Asset Number(s): To the best of my knowledge, the abow(Was) WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: . Technician: — hc ferent gf This report indicates\pur inspector's observation and testing results based on the site condition and contractor's activities. This Information is subject to review prior to final submittal. By signing this report, out inspector does not accept responsibility for validity of the resutts. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States . Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc EFFECTIVE: 4/22/2009 BAK raZaAN «associates, INC. GEOTECHNICAL ENGINEERING @¢ ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING & INSPECTION June 17, 2010 KA Project No.: 106-10051 Building Permit No.: BLD10-004 Ms. Dana Michelson Jefferson Healthcare 834 Sheridan Avenue Port Townsend, WA 98368 RE: Jefferson Healthcare Tenant Improvement MRI Port Townsend, WA Dear Ms. Michelson: In accordance with your request and authorization, the following test data are presented on the following reports, which are enclosed: April 29, 2010 Cylinder Report No. 35345 — 28 Day Break Referenced concrete reports and compressive strength data will be mailed following 28-day tests, if applicable. If you have any questions, or if we can be of further assistance, please do not hesitate to contact our office. Respectfully submitted, fo~ Sk, Penn Seely, Laboratory Manager Peninsula Division ——-. PS: md Enclosures \\<{ ce: City of Port Townsend—Fred Slota. With Offices Serving The Western United States 1230 Finn Hill Rd NW Ste. A ¢ Poulsbo, Washington 98370 ¢ (360) 598-2126 ¢ Fax: (360) 598-2127 Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO Wai 98370, (360) 598 2126 Project No. 106-10051 Cyl. Code P17717 PourDate 4/29/2010 Report No. 35345 Weather CLEAR Jurisdiction CITY OF PORT TOWNSEND Permit No. BLD 10004 Project JEFFERSON HEALTHCARE Engineer Location JEFFERSON GENERAL HOSPITAL Architect Client JEFFERSON HEALTHCARE Contractor ANDERSON Field Data CYLINDER REPORT Reported Batch Data Concrete x Other Design Actual Weights Weights Supplier COTTON Plant No. Site Mix Mix No. - 40COM654 Cem. Ibs. - 610 Mix Air Unit F. Ash Ibs. = = Slump Temp. Temp. Wt. C. agg. Ibs. 1 PEA 155 Time Truck# Ticket # % Air (in.) (F) (F) (pef) C. agg. Ibs. 2 0.75 1625 8:35 45 470 - 8 64 50 - C. agg. Ibs. 3 - - Sand Ibs. - 1318 Water Ibs. - 28gal Placement Area Air Ent. (oz) = 7 Location SLAB, MRI TENANT IMPROVEMENT. SAMPLED AT Other(oz) POLY 21.6 0z 4 OF 12.5 TOTAL YARDS PLACED; SOUTH, CENTER OF Other (oz) GLEN 23.9 oz 8" THICK SLAB FLOOR. Other (02) - - Other (oz) - - Water Added on Job (gals.) Field Test Methods Remarks PLACED BY BOOM PUMP; CONSOLIDATED BY X ASTM C143 ASTM C138 MECHANICAL VIBRATION. X ASTM C1064 ASTM C173 X ASTMC31 Other Inspector LOWELL DAVIS Laboratory Data Design Strength 4,000 @ 28 days Date Specimens Rec'd. 4/30/2010 Cyl. Test Field Max. Comp. Tested Break’ Laboratory Code Date Cure Age Dim. Area C.F. Load Str.(psi) Set# By Type] Test Methods P17717 5/6/2010 7 4x8 12.56 60430 4,810 ZL 3 |X ASTMC39 P17717 5/27/2010 28 4X8 12.56 79210 6,310 AC 3 ASTM C109 P17717 5/27/2010 28 | 4X8 12.56 78560 6,250 AC 1 ASTM C617 P1717 5/27/2010 28 4X8 256074230 8,910 AC 1. ‘|X ASTMC1231 P17717 | | Ld a | | ASTM C780 P17717 ae 1 }] Other P1717 |U L—/ P17717 | _] Test Results Remafks FR 119581 | X Conforming ft Reviewed By pr” Date Reviewed Non-Conforming Codes for Break Types: 1:Cone = 2: Cone & Spiit 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C-39 +/- 8% Form 03101 Revision 2 Effective Date 12/02/02 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 weitten permission of the client and Krazan & Associates Krazan & ASSOCIATES, INC. GEOTECHNICAL ENGINEERING © ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING & INSPECTION April 27, 2010 KA Project No.: 106-10051 Building Permit No.: BLD10-004 Ms. Dana Michelson Jefferson Healthcare 834 Sheridan Avenue Port Townsend, WA 98368 RE: Jefferson Healthcare Tenant Improvement MRI Port Townsend, WA Dear Ms. Michelson: In accordance with your request and authorization, the following test data are presented on the following reports, which are enclosed: April 6, 2010 Field Report No. 119424 April 12, 2010 Welding Inspection Report No. 8529 - WIS Referenced concrete reports and compressive strength data will be mailed following 28-day tests, if applicable. If you have any questions, or if we can be of further assistance, please do not hesitate to contact our office. Respectfully submitted, Penn Seely, Laboratory Manager Peninsula Division PS: md Enclosures cc: City of Port Townsend — Fred Slota With Offices Serving The Western United States 1230 Finn Hill Rd NW Ste. A ¢ Poulsbo, Washington 98370 ¢ (360) 598-2126 © Fax: (360) 598-2127 i tear e3kKrazan & Associates, Inc plebr Weare tet 119424 GEOTECHNICAL ENGINEERING *® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: b Ry £r\ 1010 contractor:___ AND$ 29% NJ PROJECT#:__ [0p * 100S5"' Jurispiction:_ (ty 0¢ PAT TowNySEWh PROJECT _IZeEZLSON Keath Ude PERMIT#: @LD JO- OOY LocaTION: Poe T TowNsévin we | inspector KAWUs Low Bin S KRAZAN PROJECT MANAGER: ___ 7] 4 gq WEATHER: Twte2iod_ TEMP: (yl ° KeAzan Wee on sche Ak Reouest of Cowtaeacton (oe Sthuctudal Wrsaty Special Tvspection). STEVE DAU, 2.02. CAVE Verbal approval foe on sts Mino at GRout *Culefa) REL, jo follow. low ita BeGun hsembl, ot CMY. wAll pW WEL loom, MetAe USED WAS Design Mx f2Ro brane Tups S Mortage. W) 2¥4 Com peed or! Kw Cnet Foe IMO Tect Data. See C2 4404) | Foe Details Desibn mi Peo Gitane Conese Ghout mix who Site WKED AN PlerB 1) S4id wall at 0432” Ltt. (4) 4KG Completa oul sus ples Cast fot lab Test 04th. 6t¢. 140% 1 Fok pe raul YAS. Geneed Notes [oe dome dsssions Tes tin o- - << CL. 49090 Foe. DsTRils - REIN) LaeC Wl STL oesBeve dD to Bs 1670.0, Vontial: . thts At SHEesT— S-H_ 6 £ Lov FAR wieaActog@ Tied Remon STteEL INTO Gy igtiNG CMU WALL Peeyswoiculae to loysteudep will By DAWG wo TwteQioe Ws BBV Awd PlacinG Ren Coen Steel 3” mtd Syishwe Hollow Aell Aud Equipment/Asset Number(s): C, {1} IW te witty Edourt Per 6.0,K.-. f£ Twsteuctronvs - REZ. To Follow. To the best of my knowledge, the sbove(aae / WAS NOT performed in accordance with the approved plans, cations, and regulatory requirements. Superintendent/Representative: YZ Zz This report indicates our inspector's 's observation and testing results based on the site condition and contractor's achvities. This informatio i informatiok is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc EFFECTIVE: 4/22/2009 To WIS DATE 4/12/20 NO. 8529 WELDING INSPECTION SERVICES inspection, NDE, Testing PROJECT Jefferson Healthcare P. 0. BOX 1044 SUQUAMISH, WASHINGTON 98392 LOCATION Port Townsend, WA (360) 908-4386 CONTRACTOR Andersen OWNER weldinginspectionservices@gmail.com WEATHER N/A inside TEMP. ambient PRESENT AT SITE Contractor, Allform Welding Krazan and Associates, Inc. Andersen Construction PERMIT NO. BLD10-004 Dana Mickelson Pa Building Official-City of Port Townsend, WA of Krazan Job No. 106-10-051 SPECIAL WELDING INSPECTION PER IBC 1704 AND AWS D1.1 Requested for third party, independent, special welding inspection at the start of welding. Arrived at the site 0815 hours, met with Superintendent, Larry Snow, reviewed drawing notes and details S-3, viewed Andersen Safety film, reviewed hospital and Andersen safety and work rules. Observed and inspected installation of W10x22 support beam, mounting plate to CMU with “wedge” type anchors, welding of beam to embed plate, joists to beam and embed plate, beam connection knife plate to mounting plate. All welding SMAW, E7018 electrodes, prequalified joint design per AWS D1.1. Installation of beam and plates and welding performed by Allform Welding, Inc.. WABO/AWS certified welder (Shane). Mounting plate installed with 4, 3/4x6 4 wedge anchors per specifications. W-beam installed and welded in place per specifications. Joists welded to beam and to embed plate at top of CMU wall per specifications. Welded connection knife plate, mounting plate to W-beam web, installed and welded per specifications. Temporary bolts (two % dia.) installed to connect knife plate to beam web. Replace bolts with HS A325 bolts and tighten to specification (advised Superintendent). All fillet welds inspected with light (16 welds total) and ACCEPTABLE PER AWS D1.1 VISUAL CRITERIA, MARKED VT-OK 4/12. ae SS a 43Krazat. « Associates, Inc. FIELD REPORT NO: 119584 GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: 6 y /R9/ 2/0 PROJECT #:_/@o G-/ooS/ PROJECT: Des44250W HEgEIH CIRE TENANT LOCATION: Deereeson Gewese pos p72 KRAZAN PROJECT MANAGER: JIB LINDER SON PRT TOWN SEND CONTRACTOR: JURISDICTION: ¢775 a /2 PERMIT #: 42 D- vomov INSPECTOR: tow eve DA Ss WEATHER: CLEAR TEMP: 475 KRAZAN TAISPECTIOR OW SITE FOR S$PECISE TNE BECTION OCF SONCRETE / Fe yee 27 SAAB FxrO0R ~-ZOR £77 QF Tan PRovUrE MEN? FRO » a DIR IX ITE LS 2225302 YARDS OF Cowon MED = 211% Eee Covcréle , 22K YOCMm GSS lavv9 DS “2, ACER Lag LBOEOKF) Pt ny? FARO GY A ROOF WPL WIN & DEE COANE RETE LASS Kye TESTED Form Dz une, SOW seZsiIQATE SD Lig. PIE AA NICAL LIRR ATIR +H) «CON CHREZE ONE SET OF Y- ox CO ei RES SION TEST SAW ES WM FEwBE CesT LEM) PERATA RE 2 T7000 wAS A939 Su REDLAND ARIE D FO F-BAS AOA THE ADPHEXTARE CLENIA HY SEE 7 LLNDER REPT ae eee Fae COM 5S) LEY ZO OpTi pit Zf Seite sn e LEST OATA. <¢ nie G WE APR 2-9 2010 CITY OF PORT TOWNSEND DSD | Equipment/Asset Number(s): To the best of my knowledge, the abo Superintendent/Representative: S / WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Technician: Y ; = Zz This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc. EFFECTIVE: 4/22/2009 inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. x a= FIELD REPORT NO: 179885 22krazan Associates, Inc. 119585 GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION f DATE: O5S/OZLAC/O CONTRACTOR: 4 v7 £2 son PROJECT #:_ 4224 - JURISDICTION: 7 Je. 3 6 2? Fee ey) PROJECT: J £4 4e30so" tol Ebvo teer? PERMIT #: 2 £) LOCATION: _J4 #2 50% Ging gat “etary INSPECTOR: LO Kee sees 5 KRAZAN PROJECT MANAGER: Ji WEATHER: 32-57 ga gu TEMP:4 7° a == - KR KS ZAIN CASSECI OE! OY WWE fox SPEC Ae LysiecIiey 2f zx 2a bie Bei Ce Bot Fibe & aT LOT Seu 74 ENDinw FZ ¢ A EXSIGI WE oo P22 i tt TD a NE ZEEE OF ANE LPoxw fo JHE Exte Fine #HOOFe Ds DeEscey £Q 2X REF 23 ME WIION . Ae _ ILE _ oe itt . fe THREAD Eo Jada ge GOED re 4 Tn Je oc 4 tt Ax 3 xX AB IM GEE AAITIIC KHER fat Nat Hwe a “er = - 7 Ate, _ . i OF _ 322° OW cén7e 8 JWE 44 eT Ot Kom’. » Va MO 2O, LAY , tats l De Bible Ss bd 5S 4 ££ Dp. Met! << LEINED we PH Con pees,€ O Ferm wacgar& Fv) ivowey tf) A564 5 f%e 41439 EWOXG GROAT ANchoY Ly sJIFoFF 2 OF 4~SLEE4 41x TES THAT ue AS fa Zv FO ExXSeFisy & 12717 SMHRG te CB Lab? MYA EST wee Pook wA7s, 4 SS D9 Ati It OOP _9.- Ff, aati 2 PETAL 2, Mottlouw Lew 66 aypplacsiiox —_ 7 ra 4 > f of > a (O¢ ES, WELL CLEIPNEQ wit AiR AND rus 4 5B CREME 2D 3 £26640) ee, 7 : ye ter WTA A bF fb RO FF LOXKA, fcr, WAS tt SED 9S SK SGFAEW~ OE Dg LIMO ita X = oO © / “7 te ra - - . ae je _ a 5 > _ Ee _ POAC CAPE OF FHS 3Hte CaI 6 WHE KE LANA Zk KESZFED ‘Se ON £ ACA! 51 DE OF Pocock u Ju, ~, J 2.50 EXPINSION tucto® TNEpE Fron FAT NF we Cite Ww 4c LOD Kat Ech ee) 5S DRAWN CNW SHEE 7 Ss alr A eo saad 3 7B MA t1ET EK GIBNGION (fet FS a te FPS 47 4@ ON CEMER Ait ISON) EP BEHHERT (26 1201) DF e& SYOLE tt ERS pr SET 7 f AS DRAWS FOR ATTACH RIEN ON £AOX DIDE OF NEL Ceryn bh YEO 7 Equipment/Asset Number(s): To the best of my knowledge, the above WAS) WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: - Technician: ayes = ; , Sif ij ae ae ee This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. The iriformation 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc EFFECTIVE: 4/22/2009 ==Krazan & Associates, ui cINDER Inc. REPORT NO.: 35345 GEOTECHNICAL ENGINEERING »* ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: OFLU LOO CONTRACTOR: FW PER SIM PROJECT #4: 4 - £20 5/ PERMIT NO.: {3402 - / ODODE PROJECT: _ 74 #4 ¢4som fet: tude Te Aa INSPECTOR: as Dit Eee s #25 LOCATION: f LKEE BO) BENE ERE LORI TE JURISDICTION: ca Gat fed f fpawre 5 FAO KRAZAN PROJECT MANAGER: rf WEATHER: aL Eg TEMP: 47° Field Data Reported Batch Data Concrete | x | al | Cement Type| 2 Za Se | Supplier le OWOK Kep1 —a1/x Plant No. Ea Site Mix = | Design | |actual| Xx | Mix No. ) Mix _ Air Unit Cem. Ibs. Ok Slump Temp. Temp. Wt. G/048 Time Truck # Ticket # % Air (in) (F) (Fy (pcf) F. Ash Ibs. —= le:a5\L¢s_|l470 |L— JL 2” |lewleclL | |} Oats =< C.agg.lbs.2} , ag Pa SBS, 28 Placement Area C.agg.ibs.3) #6." Wl xe a5eF Location S LTB fF A? LF ENA 2 PP ROVE MENT « Sand lbs. 1313. £8 Sam gt62 OT Y OF (215 O GIRO (74 0L0, eel AS Goueor) South, CANTER OA 8 Fistck SLATE FLOOR « AMWMUS 2 ner | 2/oe* Other Are 23. Z3 o2 Air Ent. (oz/cwt.) | ees Remarks JZ AC £}? Og £3 CD STA jie eu sf? : _ _. Water Added on Job OM S066 297 ET Be Py] E CHIME AL VIBRATION ain (gals.) AS Field Test Methods Please refer to Field bee t No. Z t FEG/ ASTM C143 asTuci38[__| ~ asTuciec4 A | ASTM C173 [| aa Inspector | , a ee es ee wail CARER ASTM C31 Other [| Laboratory Data Design Strength @ 28 days Date Specimens Rec'd. ; = | Cyl. Test Field Max Comp. Tested Break Code Date Cure Age Dim Area C.F. Load Str, (psi) Set # By Type unt kicthans LE _| 7 |4r9" ASTM C39 [eh ‘fan aa\|_ | = ast{ucioa«=[_| 5L31 aa\|_] UJ | astucei7 [|_| i } lid i Ps l Amr favatls Hh i ASTM utes! [_] le wal f ee Per Uber 28 coy astmcio19 [| | HEHOF PERF HAS END i psp Test Results _sogeatamanr a Ramarie nami [| Conforming [| Non-Conforming 1. Cone IX 2. Cone & Split Measurement Uncertainties: ASTM C39=Cores +/- 8% ets Results Reviewed By Codes for Break Types: Date.Reviewed 3. Cone & Shear ‘Al 4. Shear /| 5. Columnar (Split) | Ne FIELD REPORTNO: 119580 43KkKrazar. . Associates, Inc. GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION CONTRACTOR: LS AJIER 5 ory JURISDICTION: cry OF Sow? Ti PROJECT: tee¢-250n Mente me Tena PERMIT#: 24) ~ “Cog LOCATION: 72 £K£ E Rscw (En éote Howitsl Fett Fawwceno INSPECTOR: 4Zowée4 O41 s H KRAZAN PROJECT MANAGER: Tr WEATHER: ZwWs- DE TEMP: 4° DATE: OO 97/723/ 20/2 PROJECT #:_ 40 @ 7 4OO%S57 INSIDE CT ION OF PFIN FORCE VENT STEFF 2 > A RA 2ANW LwWSPECTOR OW SWE FOR SJVIECL HS oT Ok SL LL BAT ee FLnok, FIRE Eime2RowEe itn’, Sf AREA OF FéooR, § IN CENTER OF 6 (ELAL n wy) TH %é" REBAR Ve Oi. BACH Wis ow 8 Dot UAAPoOR (£3 DAR LER, foo wy te TH PACE beste 422 EDBC6ES SFALED weir £717 ih y 412 DRA HH OM SHEA S-2, Q¢“o.c . AT 2 7 T2 EXSY sTtn& FOICES OF SA CAT CONCRETE. = 4, “¢ DETeavez J. AND QDWEFT @-2. BA (p24 E §& eo LA ca aa LY M266 FLGE S DAS tieweoeG FAS Fo ZED a INE TRENCH SAS Sz re gL Med itr fA oF oF a al , in 72D 2 TPR 27 Pru ES EyeerG E+) 72 FuIGe a, up Zit FB "WE PAI Ep "OL lePyPIOO MpINPRAIR TN IZA CLY way LPf 8 SPrc AT EDGE Ss ALSO PEN Lowe emEWT at £Le TRV WE FEILO, /O riste aU Week SLAG REAR TS NeAey Dar /P-2 pF APpRoUe 2 SAAN Ss ae G ie | WV fe In) APR 2.9 2010 QD CITY.OF PORT TOWNSEND DSU Equipment/Asset Number(s): / WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Technician: — ws ae X ZU. Pn ed This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 ava (253) 939-2500 EFFECTIVE: 4/22/2009 To the best of my knowledge, the abov Superintendent/Represéntative: DAILY FIELD REPORT 2009.doc ~~ = = ==Krazan & Associates, Inc. GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION _. LINDER REPORT NO.: 47332 DATE: OF /26/ 2BY/O CONTRACTOR: AN PERSON PROJECT #: 2 6.- format PERMITNO.: “(4202 /do-omDge PROJECT: V6 £6 ec eb ey NE AEF OC CAKE fi} AZ INSPECTOR: ita lew EL x 4 JAW “ity LOCATION: JE ee 42604 GEA dE bit pe Tk JURISDICTION: — <x + 7 eat Sor Fete At OD KRAZAN PROJECT MANAGER: 53 WEATHER: Za 72 108 TEMP: 4’ ~ Field Data Reported Batch Data Concrete Roe 7 | Other | a ee | Cement Type tL - £7 | Supplier Tene we ard | Plant No. Eel Site Mix Design | | Actual | Mix No. Mix Air Unit Cem. Ibs. Slump Temp. Temp. Wt. Time Truck # Ticket # % Air (in) (F) (F) (pcf) F. Ash lbs. LoolL- |= IL- dis JboleziL—_| oe Bais C. agg. Ibs. 2 Placement Area C. agg. Ibs. 3 Location £957 wAee, Doon way FNFILE (3,44 ock) Sand Ibs. Sampled AT BTM cou RSE ‘AY? Water Admixture Other ell a Air Ent. (oz/cwt.) Remarks IeACEN Pp > _ fd Zz Sy 43610 KET ‘ FOR Water Added on Job (gals.) ; Field Test Methods Please refer to Field Report No. _//P 4 77 astucia3[__ | astmcise[ | ASTM C1064 [| ASTM C173 [| inepedtor | ZEEE Dn: a | astucai |_| other| —_| Laboratory Data Design Strength Fi 2-2 ¢> | @ 28 days Date Specimens Rec'd. [ Cyl. Test Field . Max Comp. Tested Break Code Date Cure Age _ Dim Area C.F. Load Str, (psi) Set # By Type ES orig nat 5/3 72x 2" astuc39 [| 5Lad) 23 |_| te} — astucioo [| bi ay as|l_ | Yic IV ig in astucei7 [| H < AsTMCi231 [| ASTM C1019 | 291 2010 | tee | Sa Test Results DSD . Benes [| Conforming [| Non-Conforming Results Reviewed By | Date Reviewed [ Codes for Break Types: 1. Cone 2. Cone & Split {KM 3. Cone & Shear Al 4. Shear 5. Columnar (Split) | Measurement Uncertainties: ASTM C39=Cores +/- 8% FIELD REPORT NO: 119579 42kKrazan uw Associates, Inc. GEOTECHNICAL ENGINEERING ® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: “04/2G6/ 2ovo CONTRACTOR: _Jwueesow PROJECT #:_ 4QOe - yooss JURISDICTION: — +44 pment tT ook J2 7. PROJECT: 74 £<22s0w HEM CaAwe, M1 AL Suite PERMIT#:_ ALD - sO-COY LOCATION: Jz¢ ¢¢eksow GENERAL Honso1T Ad INSPECTOR: AoOuw £4 4 Dour S KRAZAN PROJECT MANAGER: TB WEATHER: zw7ee so2 TEMP: 27? A BAZAN INSECT CR ON SITE for FRroxy ANCHOR ZTNSAICTIOYN ap TF 5 29/75. DowsL SG Seau7H OF Poor , AS DR4aw Woon D-& ~Fra/h IS ALSQ TW Cont uctow wilt RFtrW32 pareg 4/9/AO/O, = MehESAT THOS £ LOCATION ONL? LD Stn Bante TAREE Lf) PT aE oT St1DE QE 7 Woon, ALL KOLES )weitlEQ Tato THe s4ucuZ OEE Of THE Exess “ = de ¢¢ _ SLAT2 ox Gud OE, opr 2 ean JTALoAg s ¥z 137 tte BO UE ZF eR AB WEA DowsL 8 y LABELED WENT ZDE BL? 2 Ff 4927/2 2 ALt Nott CAEANFI2? tists keane B3guscy AQNOQ Gol 296552) A/R» SeAPow SET £F2Xs 7 Ls gF Aton (2A TE 4/21 L AO’, tase Sis SEY ZS PEA 2D AN EEACTERES, ENSTRUCT sos 9= PB. GO Le MEF OX SATE 4 S4AmeéF- OF LID BIA AR CROAT WtAS6 SS 1 / Takes ST 4A DooktwALt. DCwysree , fast w4Ase. ani Paliwsg , aK SEF Cy ety per O £22 2T YAY 73D 2 JOR SES DATE ONE SETOF 6-224 CUASB UvreERF 22asls, po Or e s APR 29 2010 CITY OF PORT TOWNSEND Equipment/Asset Number(s): ES = To the best of my knowledge, the abo WAS) WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: Z ion is subject to review prior to final submittal; By ‘signing this report, our The information provided on this report is prepared for the exclusive use of This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This informati inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. the client. This report may not be reproduced in any format without the written permission of the client and Krazan & Assoc. Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 EFFECTIVE: 4/22/2009 DAILY FIELD REPORT 2009.doc i =z Krazar@ Associates, Inc. FIELD REPORT NO: 117733 GEOTECHNICAL: ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION pate: 4 29':/0 PROJECT #: /0§* (009/ pRrosect: LVesev Hed rh (nee, (IRL Suite CONTRACTOR: Awdeeson | 7 JURISDICTION: &/7y of foe? Tp won Goud? PERMIT#: 5. /2' 20% LOCATION: (OL _7ow/ Sen & | INSPECTOR: 7m SHUTS 5 KRAZAN PROJECT MANAGER: _ “7/2 WEATHER: «fv 76#/24 TEMP: GA Ues2AN IWsyectok__on site_fok Cpoxy AvehoR ynSpection at Cast Wall, Cerntee pwiill page Sd fot fockton Syec Show pote pace 8-4 delat 14. a / 1 Wed2dn Jiszectoa RevreweB— plan’ Ane found foles at top avd bytlom Comteém to_pJaws) Webra Location at _hett Mw? Made at apo, ($ aditleO due tod pollowEMu Wall. (we weer ot Record “ Joughlin- Beter: hundow” pdve_apppoveI Ae oF Hollow Wal Aichog SleWes , onteactoe and [tA2An Juspectar Dadve Ages! BF. fk Confobomnce. oie. ob%aved AUC folks ftiCeO zo port's pwstRuctloos, Ad hax wee cleanc® ts ipl pnsteuction ( plow biersblow). ~Jw_QdeAS of MO aondete 0 *~5 soben WAS PMC! to A dopl of Y" CooL woth Av ddecuate Amount gt Simpsox Set 2 Cex, iN Aa€AS “at Allow CSL wAl Aollow wall A Vchonk IOOLO placed) AL DIA met ae ot 6% yn Softh Cfov/el ANE then 2A bAL WA pw—E7CE pe fe. Tk, dihectione xg) zat Joal Date S PI PSON Set E* OV y= OC 3l-/l TRAZAN Ivsjectae bequeste to stan$hy while cokted S/2e poles pete PMMED An© Cleaned to [HE pus(hUye7/on€ Sa - _, Equipment/Asset Number(s): We APR 29 QU UT Ur FURT TOWNSEND “fending fi. Ff psp - To the best of my knowledge, the above WAS / WAS NOT performed in accordance with the approved plans, specifications; and regulatory requirements. Superintendent/Representative: = Technician: re i 4s / fh “F ALD FS CLE oe ~ : This report indi¢ates our inspector's observation and testing results based on the site condition and contractor's agtiVities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been prov d by others on site. 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 Krazan-& Assoc. Offices Serving the Western United States Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 EFFECTIVE: 4/22/2009 Bothell (425) 485-5519 NAV FIELD REPORT 2NN9 doc 3 FIELD REPORT NO: 117896 43Krazar. . Associates, Inc. GEOTECHNICAL ENGINEERING *® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: ”- §-fe CONTRACTOR: Zu» lew Aipsewity PROJECT #:__~2¢ + “acs JURISDICTION: 77% 477" Foawssnd PROJECT: dete e804" ACACIA! CAE PERMIT #: Z.ves9 -S LOCATION: “F?. Zoedn“serd INSPECTOR: 44 Kor! Ce4DE KRAZAN PROJECT MANAGER: ia) WEATHER: AF Cee OF TEMP: “<< * LIER GANI PEPRESEN TH tts OA Sime pate ISA ATIC A! Ad Bho Cc CPACEMM ENE. © AME nie, fee PPR ELM IA TURE ORCL CINTA CCFO PT x SS OR SPC EY DEVAN BAL. COMTRAAHOR FORAGE GHONT Kal EXIST Ceiid CREA 8 new) Peotc0ng, Ath NEW Cattl WAtby, yoy BAKE, FEPRECA MAE BK PAO FORCE FR FOI Get FRAT ReZewEn fir _AWe ACFE d @ WE) AMel Aion CORE (2 1b CofE /S > ~— ZEPRESCWIATIN: ORM NN SAPTPGS FOR ES FES AO CASI " Geel SRECMMIENS, SEE FES Feredejr Fey CR. te SPO?Y. APR 29 2010 Equipment/Asset Number(s): DSD CITY OF PORT TOWNSEND To the best of my knowledge, the above WAS WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Representative: Technician: This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This information is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. Bothell (425) 485-5519 DAILY FIELD REPORT 2009.doc Offices Serving the Western United States esham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 EFFECTIVE: 4/22/2009 — oo 225 _..LINDER ==Krazau & Associates, Inc. REPORT NO:: 49074 GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: HE fo CONTRACTOR: TAL NMS Cpe et TP Sea ley PROJECT #: Abn Fee b PERMIT NO.: em of PROJECT: 4 ftSen’ AGA oA INSPECTOR: — 44 ew? Ee LOCATION: ye 7SeaSen? JURISDICTION: <7 77 €f 77. Feet Sev) KRAZAN PROJECT MANAGER: FR WEATHER: ¢% ecetey TEMP: “% * Field Data Reported Batch Data Concrete | | o Other | 4 Bidet | Cement Type | afrdl, | Supplier | WESICAL FIVK | Plant No. [ Site Mix [>< | Design | | Actual| * | MiXNo.PeeS pont ll da Mix _ Air Unit Cem. Ibs. EO Slump Temp. Temp. Wt. Time Truck# Ticket # % Air (in) (F) (F) (pcf) F. Ash Ibs. = Ve en ev Jee TE _) |] ono C. agg. Ibs. 2 Placement Area C. agg. Ibs. 3 _ Location) eres AMER Tat Ve? OS Bet Sinz Sand Ibs. _ orien EEK PS rt NE Ped FEA Water Sas Admixture - Other ~ Air Ent. (oz/cwt.) ~ Remarks} Agere Pesce £60 Buecwer ANS PAG Water Added on Job a : 4 Taner PO Bers Cate AC MED Tei OAg (gals.) cm £36 Field Test Methods Please refer to Field Report No. ere astuci43[ | astmcise[ | ASTM C1064 ASTM C173 [| a a Ps Inspector ae astucat}~ | other[ | Laboratory Data Design Strength | #cex @ 28 days Date Specimens Rec'd. Cyl. Test Field Max Comp. Tested Break Laborator i ; y Code Date Cure Age Dim. Area CF. Load Str, (psi) _Set# By Type Test Method v-7F || 7 || oxexe, | | ASTM C39 [| s- ce || | | | astTMcio9 [| Sp || | Fe GLE WWE astucei7 [| Sule off L ASTMC1231 [| ASTM C1019 A H NIN a w os Test Results ee CITY OF PORT TOWNSEND wees DSD ; ‘Remarks [| Conforming [| Non-Conforming Results Reviewed By | Date Reviewed [ Codes for Break Types: 1. Cone 2. Cone & Split 3. Cone & Shear A 4. Shear 5. Columnar (Split) | | Measurement Uncertainties: ASTM C39=Cores +/- 8% sae FIELD REPORT NO: 42Krazan « Associates, Inc. . - 119424 GEOTECHNICAL ENGINEERING °® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: b Ayds\ 7010 contractor:.__Awbe2Sen _ PROJECT#:_ {0p * [oO ! gurispiction:_ ity of fo2T Tow wyséwd PROJECT J4E FE RSON Ke arip CAbe PERMIT#: @LD |O- COU Location: foe Tt TowNssvi2 wi INSPECTOR, KAWas ZoW Bin S KRAZAN PROJECT MANAGER: __4) Y ‘4 WEATHER: “VL wte io’ TEMP: (y/ ° aia VoAzan ep on site Ak Ceousest of Commwact ot Kore St guctudal W AsoN 2y Special Tals pection) STEVE DAU, 2.02. 6 AVE Vezbal arfeovél Foe on Sts Wiwie nf Geort’ (a/ofo) RET, to Fallow. (hw itActoe Berun hese blu ot GWU. wAll ip MET @oom Mg@tAe USED WAS Desien Mix (20 brane Tues S Mortage, 4) 2¥4 compétsyar! SAmplec (at foe [WB tee? Data. See C@ 4904)! Foe Details D6leN mi Peo Gitaoe Copgse Gout mix Who $/tZ WE AUO Place 1N SAiD WAI pat 0732’ Litt. (Q) axe (lompeessio sAmples Chet fot lke TéoT DAA. 6&6 OP 449067 Foe petals - (2) Seartbe!” Foisuns Cast Peg. Genecal Notes Kok 7 Mowotsesion Tet - See G2 44040 FoR DéTAils - pein lozowG STZ otsEevED to Bs 16" 0.0, Vortcal: AUD D2 0.0. Mogizomal Yee SeciticAtows At SHésT S~H_ 6 £ App hove d (ian. - Covteactoe Tien Rewhodoue Stzel ipto' GyicgtinGg GWU WALL PeeysydiculAd to Mrysteucep All By Detling wito Twiedi0e We bBo And PlacinG Ren boeewnl $44<Lb 4” wuto Syistiwe Hollow Cell And Equipment/Asset Number(s): €, |! IN be War ts Giowr Pee G.0. K. TypsStRactrons : Qpr. To Follow. To the best of my knowledge, the sbovefvse / WAS NOT performed in accordance with the approved plans, pecipr Superintendent/Representative: epee Z Z LL. APR 99 910 | y CV This report indicates our inspector's observation and testing results based on the site condition and contractor's ‘aktivities. This waceenatich is subject to review prior to final submittal. By igning this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. > sand Beutatory requireme . = Cy Of pany ——_—— Offices Serving the Western United States OSD Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc EFFECTIVE: 4/22/2009 = ee = a5 GvLIND €23kKrazan & Associates, Inc. tole 499099N GEOTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: G Ape: | Zoro contractor: AW dz 2ope.n/ PROJECT#: (06 jiv0g ' PERMITNO: fi DO jg- O04 PROJECT: SZECS@SON HEAL CA ze inspectOR kAWsE2ON Be NVS . LOCATION: Poet TOWNS?tVP WA JURISDICTION: City 04 okt Townséem 7 KRAZAN PROJECT MANAGER: Ww) B WEATHER: _ i Wars (DE TEMP: L } e Field Data PRISMS Reported Batch Data Ve Concrete | — | other |G Zon te | Cement type|_b~ TT | Supplier |p35rgn WU | Plant No. Site Mix Design | >< _ [Actual | MxNo.|%po Grerioe CoARbE A Mix Air —_ Unit VA Semabs. 200 / Slump Temp. Temp. t. Time Truck# Ticket# = % Air (in) (F)—(F) (pct) F Ash Ibs. / . 4 ie jf a - feo II Le LS” desler | oe C. agg. Ibs. 2 / Placement Area C. agg. Ibs. 3 Wi Location’ a mA wALI@ MRI Room Sand Ibs. L. O- 42" Lift fc Zow SIAKB Water own Admixture J Other VA A D Air Ent. (oz/ewt.) rd Remarks| WiyyzO ON Gite wis F | - * Ze MEG ad cs Water Added on Job (gals.) GALL Field Test Methods Please refer to Field Report No. \ (4 Ate ASTM C143 J asTuci38[__| oo ASTM C1064 ASTM C173 [| ee perce] ober Laboratory Data Design Strength 1S00 | @ 28 days Date Specimens Rec'd. [| Cyl. Test Field Max Comp. Tested Break Code Date Cure Age Dim. Area CAF. Load Str, (psi) _Set# By Type pone cod FL uf 22 Favs ALE IJ Ir)\ ASTM C39 [| 7 L) —— ma 1G iS j 2g | | | | astucioo = [| Y 25 ] Uj astucei7 [| 4] O AR 2 9)(ZU | ih astmci231 [| | astucio19 | | nem | si WocwD Other{[ Test Results PRism Size To B Detehumweo At LAB []contorming PeISMms Const hug} pb a 10 [ _]Non-Conforming Results Reviewed By | Date Reviewed [ Codes for Break Types: 1. Cone 2. Cone & Split 3. Cone & Shear ‘A 4. Shear 5. Columnar (Split) | | Measurement Uncertainties: ASTM C39=Cores +/- 8% a Remarks S55 4=Krazan & Associates, Inc. GEOTECHNICAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION ENVIRONMENTAL ENGINEERING U._INDER REPORT No.: 49089 DATE: bo Ag aii ZdUiVv contractor: fAW0E 2 SBP PROJECT #: 106 IDOS | PERMITNO.: BID Ju~ 00 L| PROJECT: Séreezso/ HeALtH Chee INSPECTOR: KA 12 Zon Peri S LOCATION: Pot [ow V/Ssewp UP JURISDICTION: _(), +4 of foet 4 [aw n5¢ #1) KRAZAN PROJECT MANAGER: IMA WEATHER: 7 12 Zi Temp: ( } Field Data Reported Batch Data Concrete | | Other | GZou v | Cement Wail t-f | Supplier | Dogre6 V Ww NY | Plant No. [— | Site Mix Design | x ‘| actual] | Coaess Grout mixno| feo 6¢4ve (OAds Ai Unit VA O¢e. Ibs. # Slump Tene Temp. Wt. gra Time Truck# Ticket# %Air (in) (F) (pcf) F. Ash Ibs. VA : == fi _ e t257 |_— |_L— | Mea lle i|L—=_| ] cao Z C. agg. Ibs. 2 4 Placement Area C. agg. Ibs. 3 / Location( a4, wAlL; Mes LOOM Sandibs.| * 0". 32" Likt Kom $)AB. al Admixture oO Other Lf Air Ent. (oz/cwt.) Fa Remarks LYE O = / ky on ate 3 ZMFG OPFES Water Added on Job (gals.) ‘ Field Test Methods Please refer to Field Report No. | \4 At 4 ASTM C143 [y--] ASTM C138 [| Inspector WZ Jus tep2- ASTM C1064 astuci73[__| ASTM C31 Dz | Other [| lations Data ‘ Design Strength @ 28 days Date Specimens Rec'd. F: - | Cyl. Test Field Comp. Tested Break Laboratory Code Date Cure Age Dim. Area C.F. toed Str, (psi Set # — Type Test Method W 7 |GNYe astuc39 [| 7 6/4 1P dle Ir astucio9 [|_| sf 2% LE ef 28.2" astucei7 “|_| 7 k r) asTuci231 [| =a U! APR I? 9 2) astucioi9 [| CITY OF PORT 10 OWNSEND Test Results Fearne [| Conforming [| Non-Conforming Results Reviewed By _ Codes for Break Types: 1. Cone 2. Cone & Split aN Measurement Uncertainties: ASTM C39=Cores +/- 8% 3. Cone & Shear A 4. Shear 5. Columnar (Split) | az »LINDER == 23 Krazan & Associates, Inc. REPORT NO.: 49091 GEOTECHNICAL ENGINEERING « ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE:__{ Adds | 2010 contractor: A vps esr PROJECT#: [Of, /d0g'! PERMITNO.: Bf jo-ao4 prosect: je FEZAGoN He AltA Cage inspector: Kye ea BinwS LOCATION: Pant Towwséen dD Wr JURISDICTION: & ry O+ (pet TOWNSé wD KRAZAN PROJECT MANAGER: M4 Py WEATHER: Tpyté @/ } ay. TEMP: {, 2 a” Field Data Tu pe <i Reported Batch Data Concrete] = | other| MoztAe | Cement Type |_ - Lf Supplier | Deo re) yu LM | Plant No. Site Mix Design | x | Actual| | Mix No.| DS/ 6a} Mise Mix Air Unit ace lho# , ; Slump Temp. Temp. Wt. 4 Time Truck# Ticket # % Air (in) (F) (F) (pcf) F. Ash lbs. WA a a @ 2 — 2s — = 1 I ee") a 2 C. agg. Ibs. 2 F4 Placement Area C. agg. Ibs. 3 FA Locationlaywrn wai Me] Lodm Sand is. of 24" 1, OT Freow SIAG. water] og al Admixture Y ZA. Other FA Air Ent. (oz/cwt.) 4 Remarks| Dez oxeation Pak MEG. Specs | Water Added on Job (gals.) L/—|] oe Field Test Methods Please refer to Field Report No. | (P4724 astuci43[y | astmciss[ | ASTM C1064 i] ASTM C173 [| wepocir (Pee Peer | rsrncs X] omer] | 7 AO Le Lee Laboratory Data Design Strength @ 28 days Date Specimens Rec'd. [| ee Age Dim. Area GF. Load St, (os)__Set # yy Type 1 iterate y [% VN2¥4 astucso = [i 6/Y 2 _ | astucioo [| Al ad mE iG el Wille all astucei7 [| ‘ ee oh | astuci231 [| | | pa all, on 5 ss cioro9 [| CY OF PORT TOWNSEND Test Results Remarks “ : = [| Conforming [| Non-Conforming Results Reviewed By i | Date Reviewed [| Codes for Break Types: 1. Cone 2. Cone & Split 3. Cone & Shear A 4. Shear 5. Columnar (Split) | | Measurement Uncertainties: ASTM C39=Cores +/- 8% . a= FIELD REPORT NO: 42Krazan uw Associates, Inc. 117924 GEOTECHNICAL ENGINEERING *® ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTION DATE: “4-€ -9p 0 CONTRACTOR: AM OF LEY Lor fl PROJECT #: /O6- JURISDICTION: 22/4 af Poo Cote Lg PROJECT EFL EReL Weel NRE Mer TH PERMIT #: BG D [o-oo LOCATION: 43.7 SA22c06/ INSPECTOR UEFE Bout ies KRAZAN PROJECT MANAGER: 3/74 WEATHER: _&, nay TEMP: $/¢ ) an ON SHE Hy OTE Jo We he st OM ptt of af. RE STEEL Bows £05 hh tyes SLOR. Dis Dowels €preco cely MAR Bb” cd Smsoy SET c., ; E pad hy flea Oebamt Do 24 sheer ian A DU CEASED Sone’ di Rel Manske lu ke fA Lad wf Sie Sf Eericls he Deg: Lo Blrk Placto thas nels Au Nock fy MQ Popeweg lar Tru APR 29 on (LZ CITY OF FURT TOWNSEND Equipment/Asset Number(s): a DSD To the best of my knowledge, the ab en S / WAS NOT performed in accordance with the approved plans, specifications, and regulatory requirements. Superintendent/Ré presentative: Technician: , j/ A Pa CW This report indicates our inspector's observation and testing results based on the site condition and contractor's activities. This ieforration is subject to review prior to final submittal. By signing this report, our inspector does not accept responsibility for validity of the results. Some information on this report may have been provided by others on site. 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 Krazan & Assoc. : Offices Serving the Western United States Bothell (425) 485-5519 Gresham (503) 665-3574 Poulsbo (360) 598-2126 Puyallup (253) 939-2500 DAILY FIELD REPORT 2009.doc - EFFECTIVE: 4/22/2009 02/10/2010 15:55 FAX 3603799234 PURCHASING 002 ‘ 42kKrazan & ASSOCIATES, INC. GEOCTECHNICAL ENGINEERING * ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING AND INSPECTIONS January 20, 2010 KA Proposal No. P10-009P Page | of 4 Ms. Dana Michelson Jefferson Healthcare Tel: (360) 385-2200 ext 2066 834 Sheridan Avenue Fax: (360) 385-1396 Port Townsend, WA 98368 RE: CONSTRUCTION TESTING AND INSPECTION SERVICES FOR: Tenant Improvement MRI 834 Sheridan Avenue Port Townsend, Washington Dear Ms. Michelson: We greatly appreciate and thank you for the opportunity to submit this unit rate proposal for Testing and Inspection services for the above referenced project at current rates as stated below. Should you have any questions, please feel free to contact me directly or Jeff Bowers at our Poulsbo office (360) 598-2126. We look forward to the opportunity to work with you. Proprietary Anchor Inspection (6 visits) 36 hours $50.00 $1,800.00 Reinforced Concrete Inspection (1 visit) 6 hours $50.00 $300.00 Reinforced Masonry Inspection (4 visits) 24 hours $50.00 $1,200.00 Structural Steel Inspection (3 visits) 18 hours $60.00 $1,080.00 Compression Samples 40 each $20.00 $800.00 Sample Pickup 10 each $50.00 $440.00 Trip Charge (64 miles rt) 24 each $40.00 $960.00 Report Preparation 5 hours $50.00 $250.00 Project Management 2 hours $95.00 $190.00 TOTAL $7,620.00 * Prices are subject to change if this Agreement is not executed within thirty (30) calendar days. e Services will be performed on a “time and materials” basis. Any total estimates provided are merely estimates and afe not a guaranteed maximum price. A four (4) hour minimum charge applies to all inspection services and ail inspections performed will be billed on a portal to portal basis unless specifically noted otherwise. Twelve (12) hours notice of cancellation required on all jobs. Additional services requested in addition to the above will be billed at our current rates, Acceptance of Krazan’s proposal constitutes your agreement of Krazan commencing all work under our standard General Terms and Conditions, attached and incorporated in full by this reference. Please review, sign, and forward all related forms to our office within seven (7) business days. All work is subject to oredit approval and a retainer may be required priot to commencement of our services. The following items are included as an Attachment: (J Attachment A - Agreement for Professional Services and General Terms and Conditions Respectfully submitted, KRAZAN & ASSOCIATES, INC. fo Jeffrey. Mercer Regiofial Marketing Manager With Twelve Offices Serving the Western United States {230 Finn Hill Road NW, Suite A © Poulsbo, WA 98370 & (360) 598-2126 & Fax: (360) 598-2127 CERTIFICATE OF OCCUPANCY CITY OF PORT TOWNSEND DEVELOPMENT SERVICES DEPARTMENT This certificate is issued in accordance. with the provisions of the International Building Codes as adopted and amended by the. City of Port Townsend. At the time of issuance, the indicated structure and use was deemed. to be in compliance with the various codes and ordinances of the City of Port Townsend regulating construction, use and occupancy of buildings. Property Owner: Jefferson Healthcare Name of Business: Jefferson Healthcare Building Address: 834 Sheridan.St. Occupancy Group: B Type of VB Zone: P-| Construction: Date Issued: July 7, 2010 Permit Number: BLD10-004 COPY Py exo Building Official CONSTRUCTION PROGRESS RECORD CITY OF PORT TOWNSEND Development Services Department 250 Madison Street, Suite 3, Port Townsend, WA 98368 POST THIS CARD IN A SAFE, CONSPICUOUS LOCATION. PLEASE DO NOT REMOVE THIS NOTICE UNTIL ALL REQUIRED INSPECTIONS ARE MADE AND SIGNED OFF BY THE APPROPRIATE AUTHORITY AND THE BUILDING IS APPROVED FOR OCCUPANCY. STAMPED APPROVED PLANS MUST BE AVAILABLE ON THE JOBSITE. PARCELNO. _ 948321101. PERMIT NO. BLD10-004 ISSUED DATE __02/11/2010 “EXPIRATION DATE__08/10/2040 ADDRESS 834 SHERIDAN CONSTRUCTION TYPE OCCUPANT LOAD OWNER JEFFERSON CO PUBL HOSP DIST #2 PROJECT DESCRIPTION NEW MRI SUITE CONTRACTOR OWNER BUILDER LENDER INSPECTION INSP ATE COMMENT INSPECTION INSP DATE COMMENT FOOTING FIRE-FINAL 7 SLAB 1 PetolSeo En. Rep oritets) FINAL BUILDING Kil VEN, SPECIAL INSPECTION ~ UNDER SLAB iy WBING 2S whe SPECIAL INSPECTION HomBaxe Red aww SPECIAL INSPECTION MEX Gas ¢ aril bet b/2/ SPECIAL INSPECTION % SPECIAL INSPECTION File HewKke (i Rick é/ 2¥l0 SPECIAL INSPECTION r " SPECIAL INSPECTION CEILING cued Rav 6/asfo SPECIAL INSPECTION |, ' | FRAMING Kick [36/0 MISCELLANEOUS fi Fill Mad. Gas oA iso lps: 24 bw. INSULATION GWB FE iol Mec 2 b/w FINAL PUBLIC WORKS TO REQUEST AN INSPECTION CALL (360) 385-2294. INSPECTION REQUESTS MUST BE RECEIVED PRIOR TO 3:00 PM FOR NEXT DAY INSPECTION. BUILDING PERMIT City of Port Townsend Development Services Department 250 Madison Street, Suite 3, Port Townsend, WA 98368 (360)379-5095 Project Information Permit # BLD10-004 Permit Type Commercial Tenant Improvement Project Name NEW MRI SUITE Site Address 834 SHERIDAN Parcel # 948321101 Project Description NEW MRI SUITE Names Associated with this Project License Type Name Contact Phone # Type License # Exp Date Applicant Jefferson Healthcare Owner Jefferson Co Publ Hosp Dist #2 Representative Michelsen Dana (360) 385-2200 ( Contractor Owner Builder QO - STATE exempt 12/31/2010 Fee Information Project Details Project Valuation $350,000.00 Entered Bid Valuation 350,000 DOLL Plan Review Fee 1,555.94 Units: Heat Type: PLAN REVIEW DEPOSIT 150 150.00 Bedrooms: Construction Type: PLAN REVIEW REFUND 150 -150.00 Bathrooms: Occupancy Type: B State Building Code Council Fee 4.50 Technology Fee for Building Permit 47.88 Building Permit Fee 2,393.75 Record Retention Fee for Building 10.00 Permit Total Fees $ 4,012.07 *** SEE ATTACHED CONDITIONS *** Call 385-2294 by 3:00pm for next day inspection. Permits expire 180 days from issuance if work is not commenced, or if work is suspended for a period of 180 days. Work is verified by obtaining a valid inspection. The granting of this permit shall not be construed as approval to violate any provisions of the PTMC or other laws or regulations. I certify that the information provided as a part of the application for this permit is true and accurate to the best of my knowledge. I further certify that I am the ownerof the property or authorized agent of the owner. Print Na -t \e Wawa \\ lugs Date Issued: 02/11/2010 Issued By: SFOSTER ate/ I /2 Ol O Date Expires: 08/10/2010 Signature BUILDING PERMIT City of Port Townsend Development Services Department 250 Madison Street, Suite 3, Port Townsend, WA 98368 (360)379-5095 Project Information Permit # BLD10-004 Permit Type Commercial Tenant Improvement Project Name NEW MRI SUITE Site Address 834 SHERIDAN Parcel # 948321101 Project Description NEW MRI SUITE Conditions 1. Special Inspection required in accordance with Section 17 of the 2006 IBC. 1. Anchor placement Expansion Bolt Inserts Epoxy Grouted Installations Reinforced concrete Reinforced masonry Structural Steel Compression samples Shop and Field Welding 9. High Strength Bolting 10. Seismic Design Requirements 11. Architectual and Mechanical as listed on Sheet (S-0) Structural Notes Special Inspection reports shall be copied to the Building Department. These inspections do not waive the the responsibility for the inspection required by Section 109 or other sections of the 2006 International Building Code. CO SS . I SG te 2. Deferred submittal for fire protection (Fire Sprinklers) Alterations or extensions of the fire alarm and/or fire sprinkler systems require separate permits. Call 385-2294 by 3:00pm for next day inspection. Permits expire 180 days from issuance if work is not commenced, or if work is suspended for a period of 180 days. Work is verified by obtaining a valid inspection. The granting of this permit shall not be construed as approval to violate any provisions of the PTMC or other laws or regulations. I certify that the information provided as a part of the application for this permit is true and accurate to the best of my knowledge. I further certify that I am the owner of the property or authorized agent of the owner. Date Issued: 02/11/2010 Issued By: SFOSTER Signature ; Date Date Expires: 08/10/2010 Print Name ___ Complying with 7013 Flagler Road Nordland, WA 98358 ese: ASSOCIATED AIR BALANCE COUNCIL | < pe ech National Standards AccuABC i 360.385.3356 Cc 206.992.9147 steveb@accuabc.com *Except PE Stamp vs. TBE ACCUAAC900CB Accu Air/Hydronic Balance & Commissioning Testing Adjusting and Balancing [ed 10-004 Fite Jefferson Healthcare Tenant Improvement - MRI Architect: Coates Design Engineer: Sazan Group, Inc. General Contractor: Anderson Construction Company HVAC Contractor: Air Masters Inc This is to certify that Accu Air/Hydronic Balance and Commissioning has balanced the systems described herein to their optimum performance capability. The testing and balancing was performed in accordance with the standard requirements and procedures* of the Associated Air Balance Council National Standards and NEBB and the results of these tests were recorded and reported. 7/2 1 of 13 Complying with 7013 Flagler Road Nordland, WA 98358 Smee ASSOCIATED AIR BALANCE COUNCIL ~AcCcUuABC P: 360.385.1516 7 re 360.385.3356 National Standards Cc: 206.992.9147 steveb@accuabc. *Except PE Stamp vs. TBE . corr AABC- Accu Air/Hydronic Balance & Commissioning INDEX Description Page (s) Title Page 1 Index P Summary 3 General Notes 3 Instrumentation 4 Legend & Symbol Sheet 5 TAB DATA Equipment Air Handling Units Ducted Indoor Air Conditioner FC-1 and FC-5 6,7 Ductless Air Conditioner FC-2, 3, 4,6 8,9 Rooftop Heat Pumps HP=1; 2,3 10 (E) Existing Fresh Air Unit Unit # 2 ii, 12 Exhaust Fans Er 13 TAB Drawings showing ID of Outlets N/A 7/2 2 of 13 AccuABC ! wy | Summary: > m o o p Installation of the mechanical equipment appeared to be installed with good quality, and followed the design intent of the mechanical drawings. The filters were clean. The fan coil unit equipment was operated with clean filters. There were no areas noticed to have drafts or objectionable noise. Sound measurements have not yet been taken as the requirement is outside the section 15950 Testing and Balancing scope of work. However, no objectionable noise has been observed. The existing AHU supplying fresh air supplies a total of 744 CFM, approximately 200 CFM is being utilized by the new RMI area. The existing AHU noise could be substantially reduced if the fan guard were to be stiffened. (approx 90% less noise) General Notes: Corrections for temperature and altitude have been made on all test results shown in this report. Ceiling Diffusers were measured with a direct CFM read-out meter. Adjustments were made automatically for temperature. Air outlets were numbered with the closest to the fan being #1. Generally, supply outlets were numbered as 1, 2, 3,... exhaust outlets as E1, E2, E3....., and return outlets asiR1, R2; R3..,E0. All corrections for instruments used for testing and balancing are traceable back to the National Bureau of Standards. 7/2 3 of 13 # Test and Balance Instrumentation: | AccuABC ww {| Utilized Instrument Manufacturer Model Serial Number Calibration Date Yes Digital Flow Capture Hood Alnor EBT721 90844006 New Yes Digital Velometer Alnor EBT721 90846005 New Analog Velometer Alnor 3002 2/834 Yes Digital Thermometer (Air) Alnor EBT721 90846005 New Digital Hydrometer Alnor 800189 90842008 New Digital Thermometer (Air) Alnor 800188 90840051 Digital Velocity Grid Alnor 54 43 New Digital Manometer Alnor EBT721 90846005 New Digital Hydraulic Manometer Comark C9557 60115/03 New (Fluke) Digital Psychrometer CEN TECH 060600397 New Ammeter, true RMS CEN TECH 060600397 New AC Voltage Meter CEN TECH 060600397 New DC Voltage Meter CEN TECH 060600397 New Ohm Meter CEN TECH 060600397 New Digital Temperature/ Barnant Tri- 637-0000 E93001962 Humidity/ Air Velocity Meters Sense 37000-00 Data Logger for Temperature ARC Systems Smart 16709 & Relative Humidity Smart Reader Reader 2, EH-010A Sensor AC/DC Volt Ohm Meter Tripolet 630-PL T 2 Volt-Ammeter Pyramid Amprobe RS-2 Yes Multimeter (V, mV, Q, Cap, & Fluke 335 9880098 June 2010 Temp, Amps) IR Thermometer Fluke 561 New Thermometer -40 to 120F Taylor 6110M NBS Thermometer -50 to 120F Taylor NBS Thermometer 0 to 220F Taylor NBS Thermometer 0 to 220F Nurnberg’s 1806 NBS Precision Sound Level Meter Casella CEL-490 044129 6-2009 Digital Clamp Meter Johnstone H24-677 25302031 Digital Thermometer VEI PDT300 Yes RPM- Strope Monarch Nova- 2562906 June 2010 Strope dbx 7/2 4 of 13 AHU AC OR ACU ACCU ADJ P.D. AMP AVG B.H.P. C.D. CFM DIA D.N.A. D.N.L EAT EDC EDH EF EMCS EWT FCU FH FG F.E. F.L.A FPB FPM F.S. F.S.R FT. HD FTU AIR HANDLING UNIT AIR CONDITIONER UNIT AIR COOLED CONDENSING UNIT ADJUSTED PITCH DIAMETER AMPERE AVERAGE BRAKE HORSEPOWER CEILING DIFFUSER CUBIC FEET PER MINUTE CEILING EXHAUST CHILLER CHILLED WATER RETURN CHILLED WATER SUPPLY CEILING RETURN COOLING TOWER CONDENSER WATER RETURN CONDENSER WATER SUPPLY DRY BULB DIRECT DRIVE DIFFERENCE, NET DECREASE OR INCREASE DIAMETER DATA NOT AVAILABLE DATA NOT LISTED ENTERING AIR TEMPERATURE ELECTRIC DUCT COIL ELECTRIC DUCT HEALER EXHAUST FAN ENERGY MANAGEMENT CONTROL SYSTEM ENTERING WATER TEMPERATURE FAN COIL UNIT FUME HOOD FLOOR GRILLE FLOOR EXHAUST OR RETURN FULL LOAD AMPERAGE FAN POWERED BOX FEET PER MINUTE FLOOR SUPPLY FLOOR SUPPLY REGISTER FEET OF HEAD FAN TERMINAL UNIT GPM GFH HC HEATER O.L. HEPA H.F. HOA H.P. HPS HRC HVAC HWR HWS HX I.D. LAT L.D. LPS L.T. LWG LWR LWT MAU/MUA MBH N.A. N.I. N.T. N.V.L N.Z. o.D. OPEN 0.S.A. MIN OAT PF PHC PHC PMP PP Accu ABC Sym | GALLONS PER MINUTE GAS FIRED HEATER HEATING COIL THERMAL OVERLOAD PROTECTION FOR MOTORS LOCATED AT THE MOTOR STARTER HIGH EFFICIENCY PARTICULATE AIR HEPA FILTER HAND/OFF/AUTO SWITCH HORSEPOWER HIGH PRESSURE STEAM HEAT RECOVERY COIL OR HEAT RECLAIM COIL HEATING , VENTILATION AND AIR CONDITIONING HOT WATER RETURN OR HEATING WATER RETURN HOT WATER SUPPLY OR HEATING WATER SUPPLY HEAT EXCHANGER INSIDE DIAMETER LEAVING AIR TEMPERATURE LINEAR SUPPLY DIFFUSER LOW PRESSURE STEAM LIGHT TROFFER LOW WALL GRILLE LOW WALL RETURN LEAVING WATER TEMPERATURE MAKE UP AIR UNIT 1,000 BTU'S PER HOUR NOT ACCESSIBLE NOT INSTALLED NOT TAKEN NO VALID LOCATION NOZZLE OUTSIDE DIAMETER NO TERMINAL DEVICE INSTALLED OUTSIDE AIR MINIMUM OUTSIDE AIR TEMPERATURE POWER FACTOR PREHEAT COIL PHASE (S) CIRCULATING PUMP PERFORATED PLATE PSI PT. SAT S.D. SEF SF (AIR) S.F. (ELECT) SHC S.P. "W.C." S.W.E. S.W.R. S.W.S. TAB TSP UH oF P POUNDS PER SQUARE INCH PITOT TRAVERSE RETURN AIR RETURN AIR FAN RETURN GRILLE REHEAT COIL REVOLUTIONS PER MINUTE SUPPLY AIR SUPPLY AIR TEMPERATURE SUPPLY DIFFUSER SMOKE EXHAUST FAN SUPPLY FAN SERVICE FACTORS STEAM HEATING COIL STATIC PRESSURE RESISTANCE, MEASURED IN INCHES OF WATER COLUMN SIDEWALL EXHAUST SIDEWALL RETURN SIDEWALL SUPPLY TESTING, ADJUSTING, AND BALANCING TOTAL STATIC PRESSURE UNIT HEATER VOLTS VARIABLE AIR VOLUME VOLUME DAMPER VARIABLE FREQUENCY DRIVE VELOCITY PRESSURE WATTS WET BULB WATER GAUGE | DEGREES FAHRENHEIT DIFFERENTIAL (DELTA) PRESSURE OR PRESSURE DROP DIFFERENTIAL (DELTA) TEMPERATURE, NET TEMPERATURE DECREASE OR INCREASE 7/2 5 of 13 Complying with: eC ASSOCIATED AIR BALANCE COUNCIL Dee M201 AccuABC —_ REF: F SCH National Standards REF: M601 PROJECT NAME: Jefferson Healthcare- Tenant Improvement- MRI | Test Data by:| srb AREA SERVED: Equip 65-M336 | Test Date] 7/1/10 FAN / SYMBOL Supply FC-1 EQUIPMENT MFG. Mitsubishi EQUIP. LOCATION Ceiling MODEL PDFY-P30NMU-E TYPE / SIZE FC Centrifugal / SERIAL NUMBER 9001141 DISCHARGE / CLASS i SPECIFIED ACTUAL FAN TOTAL CFM- FAN 630 FAN SHEAVE M'FR / MODE TOTAL CFM - OUTLET 630 0 FAN SHEAVE DIA/ BORE R/A CFM NO.BELTS / MAKE / SIZE OAC z a N/A- Direct Drive FAN RPM TOTAL / EXTERNAL SP / 0.17 / 0.00 SUCTION /DISCHARG ___SP / MTR SHEAVE DIA / BORE REHEAT/ HEATING COIL A SP SHEAVE ADJUSTABLE? ~| ] ~ j J ~ ~ PRE FILTER / FILTER ASP COOLING COIL A SP fl VAN SOUND ATTENUATOR ASP DMPR POSITION (% OPEN) | OSA / RA / Amps: L-1 L-2 L-3 Voltage: 1-2 1-3 2-3 VOLTAGE / PHASE Vave= 208.0 | 208 / / MOTOR M'FR / MODEL AMPERAGE Aave=_ #DIV/0! / / MOTOR HP MOTOR RPM 1725 FLA / SERVICE FACTOR / 1.5 SPEED (Tap Position or VFD Hz N/A NAMEPL VOLTS / PH/ Hz 208 / 1 / 60 CALCULATE P.F. X EFF N/A HEATER SIZE / RATING THERMALLY PROTECTED BHP (Motor Output/ Fan Shaft) / #VALUE! / ##HHHE MOTOR FRAME # CORRECTED AMPS / % FLA #DIV/0! #DIV/0! . P= DESIGN INITIAL Tstrpa|__TEST1 TEST 2 | TERM [ROOM FPM __|CFM % | TAGY % % FC-1 Total: | 630 [ 0 [| 0% o [ 0% | o | 0% 0 Equipment | 336 | 1 | A_| 16x16] 1.00 630 0% 0% 0% N/A REMARKS: _ FC-1 was not ducted and therefore there was NO outlet diffusser. There was the usual combination combo supply outlets with the return air entering the unit from the middle of the 4 outlet supply slots. Steven R Burns, P.E. FC-1 7/2 6 of 13 AccuABC ae PROJECT NAME: Complying with: Ee Zee ASSOCIATED AIR BALANCE COUNCIL —_ National Standards DWG REF: M201 SCH REF: M601 Jefferson Healthcare- Tenant Improvement- MRI [Test Data by} srb | AREA SERVED: MRI | _ TestDate} 7410 | FAN / SYMBOL Supply FC-5 EQUIPMENT MFG. Mitsubishi EQUIP. LOCATION Ceiling of Control Room MODEL WSC036E3 TYPE / SIZE FC Centrifugal / SERIAL NUMBER DISCHARGE / CLASS FAN DAI SPECIFIED ACTUAL iz. TOTAL CFM- FAN 265 FAN SHEAVE M'FR / MOD TOTAL CFM - OUTLET 265 246 FAN SHEAVE DIA/ BORE R/A CFM NO.BELTS / MAKE / SIZE O/A CFM 240 315 /C N/A - Direct Drive FAN RPM MOTOF TA TOTAL / EXTERNAL SP i 0.21 / 0.00 MOTOR SHEAVE M'FR/ M' SUCTION / DISCHARG SP / / MTR SHEAVE DIA / BORE REHEAT/ HEATING COIL A SP / / SHEAVE ADJUSTABLE? PRE FILTER / FILTER ASP / / COOLING COIL ASP SOUND ATTENUATOR ASP | OSA / 10% | RA / Amps: L-1 L-2 L-3 M TA Voltage: 1-2 1-3 2-3 VOLTAGE / PHASE Vave= 208.0 208 / / MOTOR M'FR / MODEL MARATHON AMPERAGE Aave= #DIV/0! / / MOTOR HP 1 MOTOR RPM FLA/ SERVICE FACTOR 4 / 1.5 SPEED (Tap Position or VFD Hz N/A NAMEPL VOLTS / PH / Hz 208 / 1 / 60 CALCULATE P.F. X EFF HEATER SIZE / RATING THERMALLY PROTECTED BHP (Motor Output/ Fan Shaft) / / 0.00 MOTOR FRAME # 56 CORRECTED AMPS / % FLA 0% DESIGN INITIAL TEST 1 TEST 2 TERM |ROOM nO, CODE) RIZE: | Gis FPM CFM % ore % % FC-5 Total: 275 492 | 179% 0 0% 0 0% 246 MRI 337 1 A 10 |1.00 275 246 89% 0% 0% 246 MRI 337 Cc RA @ 275 RA@ 77 201 FA 169 45 REMARKS: __ Initially the damper serving the FA into the FC-5 was missing; When added and adjusted RA and FA as shown above Steven R Burns, P.E. FC-5 7/2 7 of 13 Complying with: es PWS! M201 AccuABC See ASSOCIATED AIR BALANCE COUNCIL REF: F SCH National Standards REF: M601 DUCTLESS SPLIT SYSTEM TEST REPORT PROJECT NAME: Jefferson Healthcare- Tenant Improvement- MRI [Test Data by] srb | AREA SERVED: Anteroom 334 | TestDate] 7/1/10 | \ FAN 7 SYMBOL Supply FC-2 | EQUIPMENT MFG. MITSUBISHI EQUIP. LOCATION Ceiling of Anteroom 334 | | MODEL PLFY-PO8NCMU-E TYPE / SIZE FC Centrifugal / | SERIAL NUMBER Not shown on nameplate VOLTAGE 208 / 1 60 SPECIFIED TOTAL CFM- FAN 200 O/A CFM 40 NOMINAL CAPACITY 8000 / 9000 Htg REMARKS: Deleted or NOT Used FAN / SYMBOL Supply i} FC-3 EQUIPMENT MFG. MITSHBISHI EQUIP. LOCATION Side walll of Control Room MODEL MSZ-GEO9NA TYPE / SIZE FC Centrifugal / SERIAL NUMBER 9001975 VOLTAGE 208 / 1 ph/ 60 SPECIFIED NA : REMARKS: FC-3 model changed from ceiling mounted with combo supply/return outlets to a "wall mount" Steven R Burns, P.E. FC-2 & "3" 7/2 8 of 13 AccuABC ae DUCTLESS SPLIT SYSTEM TEST REPORT PROJECT NAME: AREA SERVED: Jefferson Healthcare- Tenant Improvement- MRI Complying with: ps Zee «ASSOCIATED AIR BALANCE COUNCIL National Standards DWG REF: M201 SCH REF: M601 [Test Data by] srb | Office and Waiting [ TestDate] 71/10 | FAN / SYMBOL Supply FC-4 EQUIPMENT MFG. MITSUBISHI EQUIP. LOCATION Ceiling of the Office 331 MODEL PLFY-PO8NCMU-E TYPE / SIZE FC Centrifugal / SERIAL NUMBER Not avail on nameplate VOLTAGE 208 / 1 60 SPECIFIED TOTAL CFM- FAN 200 O/A CFM 40 FC-4 & FC-6 = 120 cfnf NOMINAL CAPACITY 8000 / 9000 Hig REMARKS: _ FC-2 and FC-6 serve the same open area; When FA damper is installed for FC-5, the total FA for FC-2 and FC-6 will be 120 cfm Currently the fresh air into the waiting and anteroom total 64 cfm. Existing supply air system will not allow 80 cfm through 4" duct for FC-6 FAN / SYMBOL Supply FC-6 EQUIPMENT MFG. MITSHBISHI EQUIP. LOCATION Ceiling of the Wait M335 MODEL PLFY-P12NCMU-E TYPE / SIZE FC Centrifugal / SERIAL NUMBER Not avail on nameplate VOLTAGE 208 / 1 60 SPECIFIED TOTAL CFM- FAN 340 O/A CFM 80 FC-4 & FC-6 = 120 cfnj NOMINAL CAPACITY 12000 / 13500 Htg REMARKS: _ FC-2 and FC-6 serve the same open area; When FA damper is installed for FC-5, the total FA for FC-2 and FC-6 will be 120 cfm Currently the fresh air into the waiting and anteroom total 64 cfm. Existing supply air system will not allow 80 cfm through 4" duct for FC-6 Steven R Burns, P.E. FC-4 & FC-6 7/2 9 of 13 Complying with: ie, DWwS! M1201 AccuABC mee ASSOCIATED AIR BALANCE COUNCIL REF: - SCH National Standards REF: M601 DUCTLESS SPLIT SYSTEM TEST REPORT PROJECT NAME: Jefferson Healthcare- Tenant Improvement- MRI | Test Data by:| srb AREA SERVED: SERVER / ELECTRICAL RM | TestDate] 7/1/10 \ FAN / SYMBOL Supply HP-1 EQUIPMENT MFG. MITSUBISHI EQUIP. LOCATION Roof serving Equip Room (FC-1) MODEL MUZ-GU18NA TYPE / SIZE FC Centrifugal / SERIAL NUMBER 0000521 T VOLTAGE 208 / 1 60 SPECIFIED NOMINAL CAPACITY 16200 / 20100 Htg FAN / SYMBOL Supply I HP-2 EQUIPMENT MFG. MITSHBISHI EQUIP. LOCATION Roof serving Control Room (FC-3) MODEL MUZ-GE9SNA TYPE / SIZE FC Centrifugal / SERIAL NUMBER 0000477 T VOLTAGE 208/160 SPECIFIED NOMINAL CAPACITY 9000 / 6400 Htg FAN / SYMBOL Supply HP-3 | EQUIPMENT MFG. MITSHBISHI EQUIP. LOCATION Roof serving BC-1 | | MODEL PURY-P72THMU-A-BS TYPE / SIZE FC Centrifugal / | | SERIAL NUMBER 8ZW00008 VOLTAGE 208 /3/60 SPECIFIED NOMINAL CAPACITY 72,000 Cooling 80,000 Htg REMARKS: Steven R Burns, P.E. HP-1, 2, 3 7/2 10 of 13 AccuABC A ae PROJECT NAME: Complying with: Be Smee: ASSOCIATED AIR BALANCE COUNCIL ad National Standards DWG REF: M201 SCH REF: M601 Jefferson Healthcare- Tenant Improvement- MRI |Test Data by: srb AREA SERVED: Equip 65-M336 | Test Date] 7/1/10 FAN 7 SYMBOL Supply Unit # 2 EQUIPMENT MFG. Trane EQUIP. LOCATION Ceiling Storage Room MODEL Climate Chager 6 TYPE / SIZE FC Centrifugal / SERIAL NUMBER U 63851 DISCHARGE / CLASS Class | FAN DAT. SPECIFIED ACTUAL FA : TOTAL CFM- FAN 744 FAN SHEAVE M'FR / MOD | TOTAL CFM - OUTLET N/A FAN SHEAVE DIA/ BORE | R/A CFM NO.BELTS / MAKE / SIZE | O/A CFM 0 0 SHAFT C/C FAN RPM ‘MOT TOTAL / EXTERNAL SP 7 7 0.00 | [MOTOR SHEAVE MFR/ MC SUCTION /DISCHARG SP / / MTR SHEAVE DIA / BORE | REHEAT/ HEATING COIL A SP / / SHEAVE ADJUSTABLE? PREFILTER/FILTER ASP / / COOLING COIL ASP . SOUND ATTENUATOR A SP DMPR POSITION (% OPEN) | OSA / | RA / Amps: L-1 L-2 L-3 ATA Voltage: 1-2 1-3 2-3 VOLTAGE / PHASE Vave= #DIV/0! / / MOTOR M'FR / MODEL Dayton AMPERAGE Aave= _ #DIV/0! / / MOTOR HP 11/3 MOTOR RPM 1725 FLA/ SERVICE FACTOR 6.3 / 1.35 SPEED (Tap Position or VFD Hz N/A NAMEPL VOLTS / PH / Hz 208 / 1 | 60 CALCULATE P.F. X EFF 13222.38 HEATER SIZE / RATING THERMALLY PROTECTED BHP (Motor Output/ Fan Shaft) / 0.00 / 0.00 | | MOTOR FRAME # CORRECTED AMPS / % FLA #DIVIO! #DIVIO! DESIGN INITIAL | stpa|__TEST1 AK FPM CFM % |TAGY ‘ Unit # 2 Total: 0 0 0 4.00 REMARKS: Unit supplier FA to the new RMI area; Steven R Burns, P.E. (E) Fresh Air AHU 7/2 11 of 13 Complying with: Sib, AccuABC Smee ~ASSOCIATED AIR BALANCE COUNCIL DWG er al rer:| Not shown National Standards DUCT TRAVERSE READINGS PROJECT NAME: Jefferson Healthcare- Tenant Improvement- MRI UNIT ID: AHU supplying Fresh Air to ...... POINT 1 2 3 4 5 6 7 8 9 10 NO. Field Dim A 568 280 306 349 342 N/A B 570 288 282 374 360 N/A Cc D E F G H i J K L M N 1138 568 588 723 702 0 0 0 0 0 TOTAL Total FPM = 3719 — — Average FPM = 371 9 Feet / Minute Total Number of Readings = 10 TEST DATA DUCT SIZE O.D. 36 X DESIGN DATA DUCT SIZE |.D. 36 X DUCT SIZE- Inches X AREA - Sq Feet 2 AREA- Sq Feet 0.00 CENTER LINE S.P. 0.317 CFM = AVERAGE FPM 371.9 FPM = #DIV/0! CFM MEASURED 744 REMARKS: Fresh air supplied into new RRMI area designed for 200 CFM; without damper for FC-5 the FA is at 226 cfm; with damper for FC-5 FA = 200 cfm Steven R Burns, P.E. Rect Traverse 7/2 12 of 13 Complying with: | ion DWG A BC BBE ASSOCIATED AIR BALANCE COUNCIL REF: M201 ‘ SCH National Standards REF: M601 PROJECT NAME: Jefferson Healthcare- Tenant Improvement- MRI |Test Data by:] (Initials) | AREA SERVED: | Test Datel 7/1/10 | FAN / SYMBOL / EF-1 EQUIPMENT MFG. Penn Ventilation EQUIP. LOCATION CEILING CABINET FAN MODEL Z6H TYPE / SIZE Centrifugal _/ A (DIRECT DRIVE) LESS THAN 1/6 HP (125W) SPECIFIED ACTUAL TOTAL CFM- FAN 150 TOTAL CFM - OUTLET 150 154 FAN RPM TOTAL / EXTERNAL _ SP / 0.14 / SUCTION / DISCHARG SP / / Amps: L-1 L-2 L-3 R DATA Voltage. 1-2 1-3 2-3 VOLTAGE / PHASE Vave= 120.0 |120/ / AMPERAGE Aave=_ #DIV/0! / / MOTOR RPM 1550 SPEED ai DESIGN INITIAL |stRA TERM ROOM| — FPM CFM | % |TAGY EF-1 Total 150 | 162 PTO 335A | E1 10x6 | 1.00 90 73 CHNG 332 | E2 6x6 | 1.00 30 46 CHNG 333 | E3 6x6 | 1.00 30 cy - q Teal ita | sees ie | REMARKS: Steven R Burns, P.E. EF-1 7/2 13 of 13 Ine GC El i} COUGHLINPORTERLUNDEEN STRUCTURAL + CIVIL + SEISMIC ENGINEERING JAN ~4 2010 | : CITY OF ar als Structural Calculations for the Jefferson Healthcare MRI Installation Jefferson Healthcare December 16, 2009 S09-1737-01 Prepared by: Stephen Day PILE COPY COUGHLINPORTERLUNDEEN STRUCTURAL: CIVIL: SEISMIC ENGINEERING Decten) Meo Ror Sepprt Beam AT DemoD Fx. Cue LIAL. De Lane? spol 7 Tepe = Zo" Re /8e p. IBF | Zk ad a mB L£/ Vi EF Loh D : ze pet. tage rt unit BEpTH To Wle Séerion Joe . y" Lemire <A Hee 7 h WIIORIS md Q " O4S" ( go>) SEE Fhiowinté cArss, pee WloR?ee — CE.7S" wpm), Feive Zh" atm Te ge Pere * wre t : Ewpo Beh AF Ex. SOA7TS 3 3 E 2 z = z Project: EFFEZSON HEH Aer Mec Designed By: AML) Date: / o/ g/o7 Project No. Client: Checked By: Sheet | of 413 PINE STREET * SUITE 300 + SEATTLE, WA 98101 + P: 206/343-0460 - F: 206/343-5691 Gravity Beam Design RAM SBeam v4.0 Licensed to: RAM International 12/16/09 13:42:47 STEEL CODE: AISC360-05 LRFD SPAN INFORMATION (ft): I-End (0.00,0.00) J-End (17.00,0.00) Maximum Depth Limitation specified = 11.50 in Beam Size (User Selected) = W10X22 Fy = 50.0 ksi Total Beam Length (ft) = 17.00 Mp (kip-ft) = 108.33 POINT LOADS (kips): Flange Bracing Dist (ft) DL LL Top Bottom 5.000 1.80 3.00 Yes No 11.000 180 3.00 Yes No LINE LOADS (k/ft): Load Dist (ft) DL LL 1 0.000 0.022 0.000 17.000 0.022 0.000 SHEAR (Ultimate): Max Vu (1.2DL+1.6LL) = 7.59 kips 1.00Vn = 73.44 kips MOMENTS (Ultimate): Span Cond LoadCombo Mu @ Lb Cb Phi Phi*Mn kip-ft ft ft kip-ft Center Max + 1.2DL+1.6LL 40.2 11.0 6.0 1.02 0.90 94.40 Controlling 1.2DL+1.6LL 40.2 11.0 6.0 1.02 0.90 94.40 REACTIONS (kips): Left Right DL reaction 2.09 1.88 Max +LL reaction 3.18 2.82 Max +total reaction (factored) 7.59 6.78 DEFLECTIONS: Dead load (in) at 8.50 ft = -0.167 L/D = 1222 Live load (in) at 8.50 ft = -0.258 Lo = 791 Net Total load (in) at 8.50 ft = -0.425 LD = 480 COUGHLINPORTERLUNDEEN STRUCTURAL: CIVIL - SEISMIC ENGINEERING Vesig0 Wea) WA fee Eyrerel> Seisuc Lenan> Foor @ pst — sage Ap 28'x 19 Co p y r i g h t 20 0 4 , CO U G H L I N P O R T E R L U N D E E N In c . Seismic corrrS. @ Jute: LAT 8.106 | Leong - 12@.77° Spa =. 0.85 Spi = O.4Z3 CHE WE WALK ABNOIST Z006 /Bc Se /smic Lenunni> (OWvsmvan VE, BASEID Cv 7re8 SFE WwEeErerir). True WEIGHT! @) 6% [7 ao | Tee WEGHT : ) ; £ = pick SELF WIEIUT @ Bp = BAG GK | Project: JEFF eSo™ Hea LTHCARE fA 1 Designed By: SMP Date: i o/ a) (oh Project No. Client: Checked By: Sheet 3 of 413 PINE STREET * SUITE 300 + SEATTLE, WA 98101 * P: 206/343-0460 - F: 206/343-5691 Conterminous 48 States 2006 International Building Code Latitude = 48.106 Longitude = -122.79 Spectral Response Accelerations Ss and S1 Ss and S1 = Mapped Spectral Acceleration Values Site Class B- Fa=1.0,Fv =1.0 Data are based on a 0.05 deg grid spacing Period Sa (sec) (g) 0.2 1.269 (Ss, Site Class B) 1.0 0.462 (S1, Site Class B) Conterminous 48 States 2006 International Building Code Latitude = 48.106 Longitude = -122.79 Spectral Response Accelerations SMs and SM1 SMs = Fa x Ss and SM1 = FvxS1 Site Class D- Fa = 1.0 ,Fv = 1.538 Period Sa (sec) (g) 0.2 1.269 (SMs, Site Class D) 1.0 0.710 (SM1, Site Class D) Conterminous 48 States 2006 International Building Code Latitude = 48.106 Longitude = -122.79 Design Spectral Response Accelerations SDs and SD1 SDs = 2/3 x SMs and SD1 = 2/3 x SM1 Site Class D- Fa=1.0 ,Fv = 1.538 Period Sa (sec) (g) 0.2 0.846 (SDs, Site Class D) 1.0 0.473 (SD1, Site Class D) COUGHLINPORTERLUNDEEN STRUCTURAL: CIVIL + SEISMIC ENGINEERING Co p y r i g h t 20 0 4 , CO U G H L I N P O R T E R L U N D E E N In c . Zeemic LEMAWD: Ve C.W Ca 5 sps Ve on(ac) = 42° WAte “Drsten: Use #5 veer @ B2'e Usk ()#E Hotere @ F2 oe Pee ArihcweD CALCOLATIOIS. MécH Exar JoisT en pb Bk Bi Zn Ben Baw Dz 2& 4.26 ( iL #38 | BM Yo 4 oo pez6k | ae Fre. | Project: EFF h4a HAH CARE /ALRI Designed By: AQMD date (Z/i¢[O7 t Project No. Client: Checked By: Sheet of 413 PINE STREET - SUITE 300 - SEATTLE, WA 98101 + P: 206/343-0460 - F: 206/343-5691 CoughlinPorterLundeen project_|Jefferson Healthcare vy _ SMD sheet no. 413 Pine Street, Suite 300 location |MRI Room date 10/8/2009 Seattle, WA 48101 P: 206/343-0460 client F: 206/3435 641 job no. Masonry Shear Wall Design in Accordance with 2006 IBC and ACI 530-05 Section 3.3.6 Input Wall Data Reinforcement Input fm=- 1.5 ksi Vert. rebar size (#) 5 fy= 60 ksi .... Spacing 32 in (8,16,24,32,40 or 48) H,, = 11 ft ....No. bars/spacing 1 (1 or 2) = 104 in Nom. Thickness = 8 in (6,8,10 or 12) Horiz. rebar size (#) 5 (4,5, or 6) Solid Grouting? 1 (yes=1, no=0) ....Spacing 32 in (8,16,24,32,40 or 48) Concrete or Clay? 1 (1=Concrete, 2=Clay) __....no. bars/spacing 2 (1 or 2) Max unbraced height = 11 ft Sas= 0.85 Wall Weight= 84 psf Seismic Design Category = D Equiv. Solid Thick. = 7.625 in Stack Bond? 0 (yes=1, no=0) Loading Input ( +) 800 ; 700 ——— Lateral Forces (kips) a Seismic or Wind ?|__1_ (Seismic =1, Wind =2) 600 X V,=| 42 |kips@ | 12 Ift g i V2=| 0 |kips@ | O [ft = Vs=| 0 |kips@ | 0 [ft 300 TA Vi=|_0 |kips@ | 0 Ift .. 7 V5 0 |kips @ O |ft > — Gravity Line Loads 0.0 500.0 1000.0 1500.0 Wall Weight =| _924]plf oM (ef) J g p NS Dead Load, Wp. =| 25 |plf Live Load, w=} 0 |plf f1= 0.5 Note: All Load Cases must fall within the curve to be adequate Snow Load, Wg. =|} 25 [pif f2= 0.2 Gravity Point Loads (kips) Dead| Snow | f2 | Live f; Seismic P, =] 1.8 3 0.7} O 0.5 0 @ 6 fft Po=] 2 3 0.7]; O 0.5 0 @ 8 ift P3=] 3 0 02] 0 0.5 0 @ 7 ifft P,=]| 0 ie) 0.2] O 0.5 0 @ oO. ft Ps=] 0 0 0.2] 0 0.5 0 @ O. |ft Adjacent Wall Dead Loads DL,;=} O |kips@ 10 |ft DL,=| O |kips@ O |ft DL3=| O |kips@ O |ft DL4=| O |kips@ 0 I|ft Maximum Out-of Plane Vertical Steel Ratio= 0.298 in*ft_ OK V corresponding to 1.25*M, = OK Maximum In-Plane Vertical Steel Ratio= 0.493 in*ft OK As Actual = 0.115 in*/ft Shear: P mnand Spacing Requirements Vu = 4.2 kips Pvert * Phorz (min) OK Smax (Vert) OK oVn = 46.02 kips OK Pvert (min) OK Smax (Horz) OK oVs= 46.02 kips OK Phorz (min) OK — Min vert=1/2 horiz OK Boundary Element Check (ACI 3.3.6.6): Not Required Co p y r i g h t 20 0 4 , CO U G H L I N P O R T E R L U N D E E N In c . COUGHLINPORTERLUNDEEN STRUCTURAL: CIVIL > SEISMIC ENGINEERING Rete) Fuse CEM [Rook sini PE Fre Le MeL sD Ombinht DESIon CRITERIA. toor de lodo- ZS&pst Oke ‘zZ @ ZS pst Lit 46 ps OL 360 (+ Torr “Evens ). CompPAtee CORRENT CELA K<OAD eof Qyetg nn Les, Citi QNBINETD> LOARDS TO (VS7S- But -up Boor + sutton - G psf | De urine - 2ps*. Mis /spruwere - Z psf RF SUPLDING ~ 2eSpok AcT = CEULLM ~ SpeX ISS poh Oe Sent APL Dengeciiwn AP Gc UNDER Pau | 4 | Sn LAD , Br sy7te ¢ ge eR. ioe (oé), Project: EI FFE San) t&4 LTHCAPRE Designed By: 24D _ Date: / f /; 1/04 Project No. Client: Checked By: Sheet Fa of 413 PINE STREET - SUITE 300 + SEATTLE, WA 98101 - P: 206/343-0460 - F: 206/343-5691 COUGHLINPORTERLUNDEEN STRUCTURAL: CIVIL: SEISMIC ENGINEERING Dron Keor rep SupporrT NEW STFEx FILA PU EG - Co p y r i g h t 20 0 4 , CO U G H L I N P O R T E R L U N D E E N In c . Synurre pe fleece Eauip. supperts ~ /000/bs MECH EQXP. EXISTING ROOF sea prsien Bl (6 Rez.) : om ' oa || [szaee | ; g Bt lio Span = {6 : ! | 10? 409 @ sy \ PP a4 fe patel = | ia | Bod Hes | AS AL _— el ‘bake | = wW6%d o€ - see 1350 fraction = 400 lbs. Desi BE C7¥P suppoe7) Sprar= 65" : P fem oe a Deez Gople. A ri L114 ly ok. Project: Designed By: Date: Project No. Client: Checked By: Sheet & of 413 PINE STREET - SUITE 300 + SEATTLE, WA 98101 + P: 206/343-0460 - F: 206/343-5691 « Coughlin Porter Lundeen . Title : Job # 413 Pine St Dsgnr: Suite 300 Project Desc.: Seattle, WA 98101 Project Notes : Printed: 18 NOV 2009, 2:41PM i SHEED NER B3- bed} Lic. #: KW-0600215 License Owner : COUGHLIN, PORTER LUNDEEN Description : ~None- a ELI Calculations per IBC 2006, CBC 2007, 13th AISC Analysis Method: Load Resistance Factor Design Fy : Steel Yield : 36.0 ksi Beam Bracing: Completely Unbraced E: Modulus : 29,000.0 ksi Bending Axis: Major Axis Bending Load Combination 2006 IBC & ASCE 7-05 esas sua W6X9 , Span = 16.0 ft Service loads entered. Load Factors will be applied for calculations. Load(s) for Span Number 1 Point Load: D = 0.150 k @ 1.0 ft Point Load: D=0.150k @ 4.0 ft Point Load: D = 0.10 k @ 6.50 ft Point Load: D=0.10 k @ 9.50 ft Point Load: D = 0.050 k @ 12.0 ft Point Load: D = 0.050 k @ 15.0 ft yceanour yeast j Design OK aximum Bending Stress Ratio 0.241: 1 Maximum Shear Stress Ratio = 0.029 : 1 Section used for this span W6X9 Section used for this span W6X9 Mu : Applied 2.068 k-ft Vu : Applied 0.6184 k Mn * Phi : Allowable 8.588 k-ft Vn * Phi : Allowable 21.665 k Load Combination +1.40D Load Combination +1.40D Location of maximum on span 6.560ft Location of maximum on span 0.000 ft Span # where maximum occurs Span # 1 Span # where maximum occurs Span # 4 Maximum Deflection Max Downward L+Lr+S Deflection 0.000 in Max Upward L+Lr+S Deflection 0.000 in Live Load Deflection Ratio 0 <360 Max Downward Total Deflection 0.143 in Max Upward Total Deflection 0.000 in Total Deflection Ratio 1345 ° Load Combination Summary of Moment Values Summary of Shear Values Segment Length Span # maxMu+ maxMu- MuMax Mnx = Phi*Mnx Cb Rm VuMax Vnx Phi*Vnx Overall MAXimum Envelope Dsgn.L= 16.00 ft 1 0.241 0.029 2.07 2.07 9.54 8.59 1.14 1.00 0.62 21.66 21.66 +1,40D Dsgn.L= 16.00 ft 1 0.241 0.029 2.07 2.07 9.54 8.59 1.14 1.00 0.62 21.66 21.66 Overall Maximum Deflections - Unfactored Loads Load Combination Span Max."-"Defl Location in Span Load Combination ; Max."+" Defl Location in Span D Only { 0.1427 7.840 0.0000 0.000 Maximum Deflections for Load Combinations - Unfactored Loads Load Combination Span Max. Downward Defi Location in Span Max. Upward Def Location in Span D Only 1 0.1427 7.840 0.0000 0.000 Vertical Reactions - Unfactored Support notation : Far left is #1 Load Combination Support 1 Support 2 Overall MAXimum 0.442 0.304 D Only 0.442 0.304 vi ‘ Coughlin Porter Lundeen Title : Job # 413 Pine St Dsgnr: Suite 300 Project Desc.: Seattle, WA 98101 Project Notes : 18 NOV 2009, 2:41PM Fe Description : ~None- Steel Section Properties : | Depth = 5.900 in [xx = 16.40 in*4 J = 0.041 in*4 Web Thick = 0.170 in Sx 5.56 ind3 Cw = 17.70 in*6 Flange Width = 3.940 in R xx = 2.470 in Flange Thick = 0.215 in zx = 6.230 in’3 Area = 2.680 in*2 lyy = 2.200 in*4 Weight = 9.123 plf Syy = 4.110 in’3 Wno = 5.600 in*2 Kdesign = 0.465 in Ryy = 0.905 in Sw = 1.190 in*4 K1 = 0.500 in Zy = 4.720 in’3 Of = 4.150 in’3 rts = 1.060 in IT = 1.030 in Qw = 3.040 in*3 Ycg = 2.950 in -) ‘ Coughlin Porter Lundeen Title : Job # 413 Pine St Z Dsgnr: Suite 300 Project Desc.: Seattle, WA 98101 Project Notes : Printed: 18 NOV 2009, 2:45PM oe : @ BE eA License Owner : COUGHLIN, PORTER LUNDEEN Material Properties. a Calculations per IBC 2006, CBC 2007, 13th AISC Analysis Method : Load Resistance Factor Design Fy : Steel Yield : 50.0 ksi Beam Bracing: Completely Unbraced E: Modulus : 29,000.0 ksi Bending Axis: | Major Axis Bending Load Combination 2006 IBC & ASCE 7-05 D(0.06) S(0.05) L4X4X1/4 , Span = 6.50 ft Service loads entered. Load Factors will be applied for calculations. Width = 1.0 ft ViM/ 5 Design OK Maximum Bending Stress Ratio 0.182: 1 Maximum Shear Stress Ratio = 0.019 : 1 Section used for this span L4X4X1/4 Section used for this span L4Xx4Xx1/4 Mu : Applied 0.845 k-ft Vu : Applied 0.5197 k Mn * Phi : Allowable 4.635 k-ft Vn * Phi: Allowable 27.0 k Load Combination +4,20D+0.50L+1.60S Load Combination +1.20D+0.50L+1.60S Location of maximum on span 3.250ft Location of maximum on span 6.500 ft Span # where maximum occurs Span # 4 Span # where maximum occurs Span # 1 Maximum Deflection Max Downward L+Lr+S Deflection 0.023 in Max Upward L+Lr+S Deflection 0.000 in Live Load Deflection Ratio 3352 Max Downward Total Deflection 0.054 in Max Upward Total Deflection 0.000 in Total Deflection Ratio 1437 seme rears te Load Combination Max Stress Ratios Summary of Moment Values Summary of Shear Values Segment Length Span # M V maxMu+ maxMu- MuMax Mnx Phi*Mnx Cb Rm VuMax Vnx Phi*Vnx Overall MAXimum Envelope Dsgn.L= 6.50 ft 1 0.182 0.019 0.84 0.84 5.15 4.64 1.14 1.00 0.52 30.00 27.00 +1.40D Dsgn.L= 6.50 ft 1 0.106 0.011 0.49 0.49 5.15 4.64 1.14 1.00 0.30 30.00 27.00 +1.20D+0,50L+0.50S+1.60H Dsgn.L= 6.50 ft 1 0.120 0.013 0.55 0.55 §.15 4.64 1.14 1.00 0.34 30.00 27.00 +1.20D+0.50L+1.60S Dsgn.L= 6.50 ft 1 0.182 0.019 0.84 0.84 . 5.15 4.64 1.14 1.00 0.52 30.00 27.00 +1.20D+0.50L+1.60S+0.80W Dsgn.L= 6.50 ft 1 0.182 0.019 0.84 0.84 5.15 4.64 1.14 1.00 0.52 30.00 27.00 +{,20D+0.50L+0.50S+1.60W Dsgn.L= 6.50 ft 1 0.120 0.013 0.55 0.55 5.15 4.64 1.14 1.00 0.34 30.00 27.00 +1.20D+0.50L+0.20S+E Dsgn.L= 6.50 ft 1 0.102 0.011 0.47 0.47 5.15 4.64 1.14 1.00 0.29 30.00 27.00 Overall Maximum Deflections - Unfactored Loads Load Combination Span Max. "-"Defl Location in Span Load Combination Max. "+" Defl Location in Span D+L+S 1 0.0543 3,283 0.0000 0.000 Maximum Deflections for Load Combinations - Unfactored Loads Load Combination Span Max. Downward Defl Location in Span Max. Upward Defl Location in Span D Only 1 0.0310 3.283 0.0000 0.000 S Only 1 0.0233 3.283 0.0000 0.000 || D+L+S 1 0.0543 3.283 0.0000 0.000 ‘ Coughlin Porter Lundeen Title : Job # 413 Pine St Dsgnr: Suite 300 Project Desc.: Seattle, WA 98101 Project Notes : Printed: 18 NOV 2009, 2:4 ner : COUGHLIN, PORTER LUNDEEN Description : -None- Vertical Reactions - Unfactored Support notation : Far left is #1 Load Combination Support 1 Support 2 Overall MAXimum 0.379 0.379 D Only 0.216 0.216 S Only 0.163 0.163 D+L+S 0.379 0.379 Steel Section Properties : ~ L4X4x1/4 Depth = 4,000 in I xx zs 3.00 in*4 J = 0.044 in*4 Sx 1.03 ind3 Cw = 0.05 in*6 Leg Width = 4.000 in R xx = 1.250 in Ro = 2.220 in Thickness = 0.250 in zx = 1.820 in’3 Area = 4.940 in’2 lyy = 3.000 in*4 Weight = 6.600 pif Syy = 4.030 in’3 Kdesign = 0.625 in Ryy = 1.250 in Yeg = 1.080 in Qs = 0.910 Iz = 1.180 in*4 $z = 0.419 in’3 Yp = 0.242 in Rz = 0.783 in Tally = 1.00 deg Eo = 0.242 in [DECEIVE i Development Services gan--4-q00 [UJ CITY OF PORT TOWNSEND DSD 250 Madison Street, Suite 3 Port Townsend WA 98368 Phone: 360-379-5095 Fax: 360-344-4619 www.cityofpt.us Commercial Building Permit Application Project Address & Zoning District: Legal Description (or Tax #): Office Use Only ‘ c Addition: 4h, Permit V . al- Block: yj tne f I N vag ED 60 - oo COITATBOS | Parcel # Lot(s): / -F Associated Permits: Ooozsgys3 allo! Project Description: MRO Duce > Applications accepted by mail must include a check for initial plan review fee of $150 > See the “Commercial Building Permit Application Checklist” for details on plan submittal requirements. Property Owner: e ev Address: City/St/Zip: Poy 24 [ oSWWUseu Ow Phone: -~ A + 3 68 Email_ DI clue sen > > Gtk. al Ly Contact/Representative;, . Name: Dow a. Wi chugiseun Address: S 34 S\ a City/StZip Pa tTowusen 2368 Phone: s— — ‘Ss ‘ s ° Email: pe _(\ Contractor: Pululre Bik Name: Address: City/St/Zip: Phone: Email: State License #: Exp: City Business License #: Lender Information: Lender information must be provided for projects over $5,000 in valuation per RCW 19.27.095. Name: Project Valuation: $ KO O; O00 Or D Construction Type: | A Occupancy Rating: J ? pe R Building Information (square feet): 1*' floor a. Restrooms: —<2— 2” floor Deck(s): —<3— 3” floor 2- Storage. <—2-— BasemenQla, 5571s it finished 7 Yes ) No Other: New O Addition Remodel/Repair 0 Change of Use 0 Total Lot Coverage (Building Footprint): (05) Boy % Impervious Surface: Square feet: Square feet: | hereby certify that the information provided is correct, that | am either the owner or authorized to act on behalf of the owner and that all activities associated with this permit will be in accordance with State Laws and the Port Townsend Municipal Code. Print Name: Signature: pate: " [a4frco9 Infection Control Construction Permit WRI- Sa te | Permit No:A9 09-4 Location of Construction: ,e"ssev So wv roject Start Date: Project Coordinator: seu Estimated Duration: Contractor Performing Work i; Permit Expiration Date: T Supervisor. | Telephone: 360 33S~2d00 eft 2.06¢ YES | NO .| CONSTRUCTION ACTIVITY [ YES | NO INFECTION CONTROL RISK GROUP TYPE A: Inspection, non-invasive activity GROUP 1: Low Risk TYPE B: Small scale, short duration, GROUP 2: Medium Risk moderate to high levels TYPE C: Activity generates moderate to high levels of GROUP 3: Medium/High Risk x dust, requires greater 1_work shift for completion pal TYPE D: Major duration and construction activities GROUP 4: Highest Risk Requiring consecutive work shifts CLASS I 1. Execute work by methods to minimize raising dust from 3. Minor Demolition for Remodeling construction operations. 2. Immediately replace any ceiling tile displaced for visual inspection. CLASS II 1. Provides active means to prevent air-bome dust from 6. Contain construction waste before transport in tightly dispersing into atmosphere covered containers. 2. Water mist work surfaces to control dust while cutting. 7. Wet mop and/or vacuum with HEPA filtered vacuum 3. Seal unused doors with duct tape. before leaving work area. 4. Block off and seal air vents. 8. Place dust mat at entrance and exit of work area. 5. Wipe surfaces with disinfectant. 9. Remove or isolate HVAC system in areas where work is being performed. 1. Obtain infection control permit before construction begins. 6. Vacuum work with HEPA filtered vacuums. CLASS III 2. Isolate HVAC system in area where work is being done to 7. Wet mop with disinfectant L/ prevent contamination of the duct system. 8. Remove barrier materials carefully to minimize ow 3. Complete all critical barriers or implement control cube spreading of dirt and debris associated with method before construction begins. construction. a3 kaye) Bf 9. Contain construction waste before transport in Da 4. — Maintain negative air pressure within work site utilizing tightly covered containers. : HEPA equipped air filtration units. 10. Cover transport receptacles or carts. Tape covering. Initial 5. Do not remove barriers from work area until complete 11. Remove or isolate HVAC system in areas where work project is thoroughly cleaned by Env. Services Dept. is being performed/ 1. Obtain infection control permit before construction begins. 7. All personnel entering work site are required to wear Class IV 2. Isolate HVAC system in area where work is being done to shoe covers prevent contamination of duct system. 8. Do not remove barriers from work area until completed 3. Complete all critical barriers or implement control cube project is thoroughly cleaned by the Environmental method before construction begins. Service Dept. Date 4. Maintain negative air pressure within work site utilizing 9. Vacuum work area with HEPA filtered vacuums. HEPA equipped air filtration units. 10. Wet mop with disinfectant. Initial 5. Seal holes, pipes, conduits, and punctures appropriately. 11. Remove barrier materials carefully to minimize 6. Construct anteroom and require all personnel to pass spreading of dirt and debris associated with through this room so they can be vacuumed using a HEPA construction. vacuum cleaner before leaving work site or they can wear 12. Contain construction waste before transport in tightly cloth or paper coveralls that are removed each time they covered containers. 1 Jeave the work site. OO 13. Cover transport receptacles or carts. Tape covering. ~~ {/—— 14. Remove or isolate HVAC system in areas where is being done. Additional Requirements: Exceptions/Additions to this permit ( \ ‘ | Date Initials are fOted by attached menoranda 4 cx Pow { Permit Authorized By: Jes \ Kod SS [~ ~Tewusertpne //- 23 -2.004 a JAN 74 2010 U) Adapted with permission V Kennedy, B Barnard, St Luke Episcopal Hospital, Houston TX, 5 CITY OF PORT TOWNSEND Forms modified and provided courtesy of J Bartley, ECSI Inc Beverly Hills MI 2002 DSD ECEIVE Jefferson Healthcare Hospital -4 0 Scope of Services JA “ Magnetic Resonance Imaging CITY OF PORT TOWNSEND DSD The scope of services is to provide high quality MRI exams. A modular unit has been providing services for our outpatient community of Port Townsend and surrounding area. We at Jefferson Healthcare (JHC) feel an in-house (physically located within the hospital) will provide Jefferson County a more consistent and convenient exam atmosphere. Jefferson Healthcare would like to offer this service for our Emergency Room and In- patients. Referring physicians and local patients have asked to have this modality here for our in-house patients. In-patients and E.R. patients would not have to drive or arrange transportation to another town/county to have these procedures performed. A new MRI unit will be placed in the hospital for ease of access for patients as well as staff. With the commitment of local referring physicians, we feel our MRI unit will support two MRI technologists performing an average of 40 patients a week to start. Exams to be performed at Jefferson Healthcare MRI suite will include but not be limited to: Exam # of exams per month | # of exams per year Head/Brain Spines (Cervical, Lumbar, Thoracic) Upper Extremity (Shoulder, Wrist, Elbow) Lower Extremity (Hip, Knee, Ankle) Throughput of Exams e Late patients disrupt the schedule and can result in higher examination costs. We will do our best to fit the patient in on another day depending how late they are and how full our schedule is. e Scheduling patients in groups with their scan type will also be helpful e MRI exams on in-patients or Emergency room patients will be performed. e Checking the MRI images. There will be set protocols for each exam. Radiologists will be interrupting MRI exams via Teleradiology (computer). Exams will be reviewed at the end of each shift, unless the MRI technologist has pertinent questions about a certain procedure. e As soon as one patient is done, the fully prepared and documented next patient should be ready to go, to increase exam throughput and cost effectiveness. e Pre-registration when the patient is scheduled will help throughput and lessen amount of time patient has to wait. e Appointment confirmation the evening before the patient’s exams will help with cancellations, no-shows and contraindicated patients. e Patients may be sedated for MRI scans. Organizational Checklist Scheduler e Makes appointments for patients e Familiarizes themselves with all aspects of MRI exams e Efficient use of scheduling time e Pre-Screen patients and have patient answer all pre-screening questions in the computer e Consultations available with the MRI technologist and/or the Radiologist for approval to do questionable outpatients prior to scheduling. e Obtain pertinent patient histories and previous films. Verbal screening again done by MRI technologist or scheduler. Patient Registration/Check-In e Patient reports first to main registration. e Patient has been pre-registered so registrar only reviews pertinent information with the patient. e Send patient to imaging department with registration paper work. Enter MRI order in computer Notify MRI technologist, via phone, of the patient’s arrival. Completion and review of screening checklist Complete MRI paper work and put together patients film jacket along with any previous films for comparison Patient Preparation e Completion of verbal contraindication checklist with Referring Doctor, scheduler or MRI technologist e Consent forms signed (when applicable) e Dress, patient will be provided with a hospital gown or hospital scrubs while having MRI exam e No dietary prep is necessary e Leave all metal valuables at home e Let JHC and referring physician be aware of any contraindications for MRI exam Supplies Needed e Contrast agents (Gadolinium) Linens (Blankets, gowns, scrubs, pillow cases, sheets) Needles and syringes, single use disposal containers for sharps Non-ferrous oxygen tanks, wheelchair, gurney, medical equipment Basic emergency drug kit (Benadryl, Epinephrine) Oxygen tubing, ambubag, bite-sticks, emesis basins, urinals, hand sanitizer, tourniquet, alcohol wipes, pate gauze, band aids, cleaning supplies e Optical discs for archiving patient information e Foam earplugs e Film e Coils for each body type and scan Film/Archive Logistics e Optical disc storage e Film with laser printer Sequences of Events for Scheduling and Preparing for an MRI study at Jefferson Healthcare 1- Referring physician requests to schedule a patient for an MRI exam and faxes referral to Imaging Department. 2- Scheduler acquires the pertinent information and screens patients for the following: e Pacemakers e Intracranial aneurysm clips, any metal in the eye e Special cases such as patients needing the following: e Oxygen, IV’s, sedation, pain medication, pregnancy 3-The patients pre-screening questions in scheduling computer should be completely answered and previous studies obtained. Pertinent information along with the previous information acquired should be ready for the MRI technologist to review the day prior. 4- MRI technologist is to review all information and review with reading Radiologist if necessary the day prior. 5- Documentation, pre-screening and screening forms, previous films and JHC paper work is stored in patient’s film jacket for easy access the day of the exam. 6- The scheduler or MRI technologist will confirm, with the patient/referral coordinator, via phone, the appointment. 7- The patient arrives. 8- Follow all steps as stated above under Organizational Checklist. Tasks and processes, which require special planning might include but not limited to, injections of gadolinium into a vein or an affected joint. The MRI technologist will review with a Radiologist before performing Gad injections into a vein, Gadolinium injections into an affected joint (i.e. shoulders, knees) will be preformed in the Radiology Department of the hospital utilizing Fluoroscopy. A Radiologist, Surgeon or Orthopedic Surgeon will preform these injections. A non-ferrous wheel chair will transfer the patient to MRI unit after the injection for imaging by the MRI technologist. Patient Screening e Monitoring Required - Must be removed or utilize an MRI approved cardiac monitor e Respirator required - Only MRI approved respirators e Pregnant - After 17 weeks, Radiologist and patients Doctor need to approve - IfMD’s sign off for exam to be done, have patient sign consent form e Infusion Pump - If ferrous material or driven by a motor, must be removed prior to scan e Chemotherapy Pump - If ferrous material or driven by a motor, must be removed prior to scan e Work with metal - Screening x-ray or CT of orbits will be preformed - Radiologist approval is mandatory prior to scan e Cochlear Implants - Ifmotor driven, can not perform exam e Neurostimulators - Must be removed e Previous surgery - Any installation of metals into body must be 6-10 weeks post op MRI technologist will always use reference guides and patient information to help Radiologist determine ferrous materials in patient. MRI Suite Procedures and Protocols The MRI technologist escorts the patient from the Radiology waiting room with all the patients’ information to the MRI suite. There are three rooms in the MRI suite. The Dressing Rooms, the Ante Room, the Technologist control room. The Dressing Room is where the patient enters the MRI suite. It includes two changing rooms with lockers. The changing room includes storage for the patient’s personal belongings. The Ante Room is where our in-patients and or E.R. patients will be in, prior to their exam. The patient has their exam in this room. There are cabinets for storage of operational coils, sponges for supporting the patient and linen. Patient Protocol after Screening is Complete Patient is offered to use restroom facilities in Radiology department prior to exam Patient is screened about previous MRI studies MRI technologist gives an explanation of procedure Patient instructed to change out of street clothes and into gown/hospital scrubs in patient changing room Patient is escorted by MRI technologist from Control Room to Magnet Room Patient is given ear plugs and asked to lay on exam table MRI technologist positions patient on table and then in MRI machine Technologist then performs MRI exam lasting between 30minutes and an hour If Gadolinium is to be injected into the vein, the following procedure is followed: 1- Patient is laying on the table 2- Technologist applies tourniquet 3- IV site cleaned with alcohol wipe 4- Butterfly needle is inserted into vein 5- Gadolinium is injected slowly 6- Saline flush is injected after Gadolinium 7- Butterfly needle is removed 8- Band aid is applied over injection site 9- Patient is positioned in MRI again 10- Patient is monitored visually and orally by MRI technologist Patient then is helped off the MRI exam table by MRI technologist Patient is escorted to the Control room and into the changing room Patient is escorted back to main hospital building MRI technologist forwards MRI exam to reading Radiologists via computer Cleaning and Maintaining the MRI Suite All cleaning supplies and linens will be kept in the anteroom of the MRI suite. Housekeeping and Maintenance personnel will be properly trained. These trainings will include videos, tests and will be reviewed annually or as needed. In emergent cases, housekeeping or maintenance personnel can be reached via phone or pager. All supplies will be stocked in the MRI suite by the MRI technologist only. Only fully trained housekeepers will pick up soiled linens. Receipt Number: BLD10-004 Plan Review Fee $1,555.94 $1,555.94 $0.00 BLD10-004 948321101 PLAN REVIEW REFUND 150 -$150.00 -$150.00 $0.00 BLD10-004 948321101 State Building Code Council Fee $4.50 $4.50 $0.00 BLD10-004 948321101 Technology Fee for Building Permit $47.88 $47.88 $0.00 BLD10-004 948321101 Building Permit Fee $2,393.75 $2,393.75 $0.00 BLD10-004 948321101 Record Retention Fee for Building Per $10.00 $10.00 $0.00 Total: $3,862.07 10-0005 01/04/2010 PLAN REVIEW DEPOSIT 150 $150.00 BLD10-004 CHECK 082083 $ 3,862.07 Total: $3,862.07 genpmtrreceipts Page 1 of 1 Receipt Number: BLD10-004 948321101 PLAN REVIEW DEPOSIT 150 $150.00 $150.00 $0.00 Total: $150.00 CHECK 080191 $ 150.00 Total: $150.00 genpmtrreceipts Page 1 of 1