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WAL-MART STORES <br /> CONCRETE MIX DESIGN SUBMI"ITAI.FORM <br /> (Section 03310—Structural Concrete and Exterior Concrete Slabs) Date I l a 3 <br /> PROJECT TYPE: <br /> STORE INFORMATION <br /> STORE# <br /> ADDRESS <br /> CITY,STATE � f j_ A <br /> GENERAL CONTRACTOR <br /> COMPANY <br /> JOBSITE PHONE <br /> PER SPEC 03310, <br /> A. CONCRETE INFORMATION 6% +/-1.5% <br /> Supplier Mix Design# 030-A P <br /> Design Strength(rc) gSaO i <br /> Water/Cementitious Rat' <br /> Total Air Conte % <br /> Total Est.Volume of Concrete CY Wallace Design Collective, PC de Ile <br /> ign <br /> Concrete Uses/Locations u, ��15, £A. El Approved collective <br /> APPoved as Noted <br /> e ❑Revise as Noted and Resubmit <br /> Mix Developed From: ❑Rejected-Resubmit as Specified <br /> ❑n Trial Mix Test Data(attach test data) ❑Retained for Records Only <br /> EAField Experience Review is only for general conformance with the Contract Documents and design concept of the <br /> Project.Review does not authorize extra costs associated with deviations from the Contract <br /> Density Documents.Markings or comments shall not be construed as relieving the Contractor from <br /> compliance with the Contract Documents and Contract Provisions.The Contractor remains <br /> 1y/2 7ry� �/ responsible for selecting fabrication processes,for techniques of construction,confrming and <br /> Wet J 1+ v I D l N G correlating all quantities and dimensions,for coordinating his work with other trades,and for <br /> rl ( tl1`� compliance with all applicable laws,regulations,and codes. <br /> Slump BY BSHONDELMYER DATE 8/29j2023 <br /> (t I")WITHOUT WR Admixture <br /> (t I")WITH WR Admixture <br /> B. ADMIXTURE INFORMATION <br /> AS-T,1 Designation Product Dosage(ounces) <br /> ManufacturerBrand oz/cy oz/cwt <br /> Water Reducing L t�q y . A 2 6 34 - &CP '36 <br /> Accelerating <br /> Retarding <br /> £,•6,t-4 --c- a- <br /> 10 <br /> 03310-27 <br /> 2101 -248-Kennewick,Washington-21794022 November 3,20 2 <br />