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Intertek Professional Service Industries,Inc. Report No: FC:07122878-25 <br /> 16750 Woodinville Redmond Rd NE Ste <br /> WtUinville,WA 98072 Issue No: 1 <br /> S Phone:(425)409-2504 These test results apply only to the specific locations and materials noted and may <br /> not represent any other locations or elevations.This report may not be reproduced, <br /> except in full,without written permission by Professional Service Industries,Inc.If a <br /> non-compliance appears on this report,to the extent that the reported <br /> Concrete Field Report non-compliance impacts the project,the resolution is outside the PSI scope of <br /> engagement.Tests and inspections are considered to be simple acceptance criteria <br /> Client: CHC OF SNOHOMISH COUNTY CC: ALEX RUIZ <br /> CONNOR WELLS <br /> 8609 EVERGREEN WAY DION KAPETANOV <br /> EVERETT, WA 98208 DON CROWLEY <br /> HEATHER BRAY <br /> MARIJANE HEPNER � <br /> Project: CHC ANNEX OFFICE <br /> EVERETT,WA <br /> Approved Signatory:Eric Allen(Director) <br /> Date of Issue: 12/1/2023 <br /> General Field Data <br /> Technician: Colby Larson <br /> Test Date: 11/13/2023 <br /> Total Concrete Placed(yd'): 1.0 <br /> Weather: Cold,Clear, Dry <br /> Test Results <br /> Set No. #Spec. Ticket Batch Time Unload Time Cubic Yards Slump(in) Air Temp.(°F) Concrete Temp. <br /> Placed (°F) <br /> 07122878-25-C1 5 1 1075479 08:10 1.0 5.00 35 1 50 <br /> Location & Remarks <br /> General Location: Wall just north of existing footing <br /> Set No. Location Remarks <br /> 07122878-25-C1 Wall just north of existing footing <br /> Mix Data <br /> Set No. Supplier Mix Design Strength(psi) <br /> 07122878-25-C1 I Miles Sand and Gravel 10155A 13000 <br /> Remark;A Fill <br /> 1.Applicable ASTM standards unless otherwise indicated:Slump:C143;Air Content:C231; Marks:SC=Condition Satisfactory upon retrieval. <br /> Temperature:C1064;Sampling:C172;Unit Weight:C138; <br /> 2.Specimen(s)prepared to ASTM C 31 <br /> Sampled from Revolving Drum Truck Mixer(ASTM C 172,5.2.3) <br /> Form No:18971,Report No:FC:07122878-25 ©2000-2023 QESTLab by SpectraQEST.com Page 1 of 1 <br />