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OTTO ROSAU& ASSOCIATES, INC. <br /> CONCRETE REPORT `- r ,<*6 `; <br /> Job Number: Permit Number: <br /> Project: Client: / <br /> Address: Address: <br /> Inspector/Date: Contractor: <br /> p > o. •� <br /> ZVQ <br /> r P y <br /> Resteel verified: Date/Checked by: �/ Grade: G Manufacturer: <br /> Supplier: Cement(lbs/type): 410/1 <br /> Mix Number: 1 9p Fine Agg. (lbs): <br /> Slump Spec: � s• 4. 1`` Coarse Agg. (lbs/size): <br /> W/C Ratio Spec: �.5 Coarse Agg. (lbs/size): �p <br /> .� <br /> Air Spec: Slag Cement(lbs): 1 F4 <br /> Total Yards: Fly's (lbs): <br /> Placed'via: <br /> Consolidated: ( S► / noAdmres(specify): <br /> Required Strength(psi): Oa <br /> Total#of Samples Ca w�e <br /> st: Total#of Field Cures: Curing Method/Location: <br /> Water C 143 C 231 C1064 <br /> Cast Samples Special Time Cubic Added Air% Conc. Ambient Truck Ticket <br /> Break Das Size Made Yards to Load Slump Test Tem —Temp No. No. <br /> j - K D Sryd <br /> Weather: Slump Range: Air% Range: <br /> gffihY <br /> y(. <br /> Inspected by: Reviewed by: <br /> Start Time: Finish Time: <br /> This report applies only to the items tested or reported and is thea clusive property of Otto Rosenau&Associates, Inc. Reproduction of this report, <br /> except in full,without written permission from our firm is strictly prohibited. <br /> Page of <br /> 6747 M.L. King Way S.,Seattle,Washington 98118-Phone(206)725-4600 or 1-888-OTTO-4-US—Fax(206)723-?221 <br /> Form No.:INSP-62-05(Rev 05/13) <br />