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D. ATTACHMENTS: Include the follo\\inc\pith this Mix Design Rc irt. <br /> Portland Cement mill test reports <br /> Q� Fly ash mill test reports where required <br /> [� Slag mill test reports <br /> [ Designation,type,quality,and source(natural or manufactured)of coarse and fine aggregate materials <br /> [� Separate aggregate gradation reports including all required sieve sizes <br /> • All gradation sieve report tests dated within 60 days of this report <br /> • Report for each coarse and fine aggregate material in mix <br /> ❑ Statement if possible reactivity of aggregate,based on tests or past service <br /> ❑ Statement if possible aggregate pop-outs or their disruptions,based on tests or past sen ice <br /> [� Product data for the following admixtures: <br /> • Chloride ion data and related calculations <br /> • Water reducing,set retarding,set accelerating,etc. <br /> ['f Measured water-soluble chloride ion content in concrete(percent by weight of cement) <br /> Concrete compressive strength data used for standard deviation calculations <br /> E. CONCRETE SUPPLIER INFORMATION <br /> Company Name Tel.# <br /> Address <br /> City,ST Zip <br /> Technical Contact Cell# J 1 <br /> e-mail <br /> Sales Contact Cell# <br /> PRIMARY PLANT SECONDARY PLANT <br /> Plant Location: <br /> Miles from Site: <br /> Travel Time to Site: <br /> NRMCACertiried: ❑ YES ❑ NO ❑ 1'E:S ❑ NO <br /> State DOT Certified: ❑ l'E�S ❑ NO ❑ YES ❑ NO <br /> Batch Mixing Type: ❑ DRY ❑ CENTRAL MIX ❑ mn' ❑ CENTRAL. Ml ' <br /> 03310-29 <br /> 2101 -248-Kennewick,Washington-21794022 November 3,20 2 <br />