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C125 <br /> INTERTEK TEST REPORT <br /> 4/24/15 <br /> Darrell Blalock <br /> Guardian Fall Protection <br /> 6305 S 231st Street <br /> Kent,WA 98032 <br /> USA <br /> Intertek Test Report Number: G102085307CRT-001 <br /> Intertek Signed Quote Number(s): 500593353 <br /> Client Reference Number: 254835 <br /> Product Type: Roof Anchors <br /> Product Models: See Page 2 of this Test Report <br /> Type of Testing Entity: Third Party Testing Laboratory <br /> Type of Testing: Qualification <br /> Test Standard: ANSI/ASSE Z359.1-2007 <br /> Manufacturer's Name and Address: (see above) <br /> Evaluation/Testing Location: Intertek, 3933 US Rte 11, Cortland NY 13045" <br /> Date(s)of Testing: 4/23/15-4/24/15 <br /> • <br /> Dear Darrell <br /> Intertek has completed the evaluation of your roof anchor model 00500 to the client specified sections of,American <br /> National Standard, Safety Requirements For Personal Fall Arrest Systems. Subsystems and Components <br /> ANSI/ASSE Z359.1-2007. The results of these tests are as indicated below. <br /> C - Tests Completed Test Date ANSI/ASSE Z359.1-2007 Pass/Fail <br /> �y Clause <br /> Design Requirements 4/23/15 3 PASS <br /> Static Strength Test 4/23/15 4.3.6 PASS <br /> Markings&Instructions 4/23/15 5 PASS <br /> Please see attached test data for details. <br /> This test report concludes the work anticipated in the testing phase of your project. <br /> If there are any questions regarding this report please contact the undersigned at 607-753-6711. <br /> Tested by, Revieal:2/71 <br /> ed by,NM�tlAl2/5/+rum>•L Andrew Rulison Chad Morey <br /> Technician 1 Engineer <br /> Performance Group Performance Group <br /> {fJ j e'Intend)Laboratory is ISOIIEC 17025:2005(CAN-P-4E)accredited by Standards Council of Canada(SCC)with the scope available <br /> 4.vS) for review at the folio ing location:http-//wwws .ca/ Noalcan/38 <br /> om This port is for the t 1 rl k Client and is provided pursuant to Me agreement between 1 lert k and es Client, inteitekis respanautha, <br /> ndl bility a limited to thetermsand conditionsf th agreement, Intertek liabilityl y p rty,otherthantotheClient- accordance with <br /> j/ dk theagreement,( ny l expense damageoccasioned by thefib prtt Only the Client WM1 dt permit copying distribution of <br /> t if ) TM report and then Ny- its Sty, Any use of the Intertek name or one of its k for the tl rr I of the tested material,product or <br /> t first be approved in writing by Intertek. The b al and test results in th report are relevant only to the sample tested, This report by <br /> y;_r -tsself does not Imply that the material,product aservleeis or has ever been under an Intertek certdlcationprogram- <br /> .�yt7?-. Intertek,Inc. <br /> 3933 US Route 11,CONand NY 13045 USA <br /> J '?- Telephone:+1 607-053-6711 Fax:N 607.755.9891 Web:www Intertek.com <br />