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12987455
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Last modified
7/30/2025 8:00:11 PM
Creation date
7/30/2025 4:16:53 PM
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Permits
Permit Address
13773 SILVER FALLS HWY SE
Permit City
Sublimity
Permit Number
555-17-002804-STR
Parcel Number
081W14 00600
Permit Type
Structural
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INTERTEK TEST DATA SHEETS Page 2 of 3 <br /> Client/Ref#: Guardian Fall Protection Engineer: Chad Morey <br /> Job No.: G102085307 Tested By: Andrew Rulison Date: 4/24/15 <br /> Product: Roof Anchors Reviewed By:Chad Morey Date: 4/24/15 <br /> Model No.: 00500 Standard: ANSI/ASSE Z359.1-2007 <br /> Quote#/Customer#500593353 TRANSCRIBED TEST DATA <br /> TEST EQUIPMENT Used for Test Description Manufacturer Control No. Model No. Serial No. Cal.Date Cal.Due <br /> X Ski.Watch FS N1179 NA NA 8/15/14 8/15/15 <br /> X Load Cell Interface L137 NA NA 1/21/15 1/21/16 <br /> X Latest Standards Used: ANSI/ASSE Z359.1-2007 Verified 8 : AR <br /> Paragraph Test Description Results Pass/Fail <br /> 3.2.5.1 Anchorage Connector Qualification Test(test section 4.3..6) • <br /> Orientation Breakage <br /> 3,600 lbs-f&hold for 1-minute, then release load 12X12 Pitch NO <br /> and reapply 5,000 lbs-f and hold for 1-minute 12X12 Pitch NO PASS <br /> 12X12 Pitch NO <br /> 5,1 Marking Requirements(General) <br /> 5.1.1; Markings shall be in English PASS <br /> ___ 5,1.2; Shall endure the life of the product, pressure PASS <br /> sensitive labels shall meet UL 969 <br /> 5.1.3 a;part#and model designation PASS <br /> 5.1.3 b;year of manufacture PASS <br /> 5,1.3 c;manufacturers name or logo PASS <br /> 5.1.3 d;capacity rating PASS <br /> 5.1.3 e;standard number"Z359.1" PASS <br /> 5.1.3 f;warning to follow manufacturer's <br /> instructions PASS <br /> 5.2 5 Marking Requirements(Anchors)5.2.5 a;the materials of construction PASS <br /> 5,2.5.b;the proper method of coupling PASS <br /> 5.2.5.c; avoid contact with sharp edges and PASS <br /> abrasives <br /> 5.2.5.d;inspection requirements PASS <br /> 5.2.5.e;warning regarding incompatible connectors PASS <br /> 5.2.5.f; stability an compatibility limitations PASS <br /> 5.2.5.g,physical hazards, thermal,electrical, PASS <br /> chemical <br />
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