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OTTO ROSE U& ASSOCIATES, INC. <br /> CONCRETE REPORT ff: - 2 7 D <br /> Job Number: _ Permit Number: <br /> Project: ( 2� ,�. �� ( �o Client: <br /> Address: Address: <br /> Inspector/Date: 1 Contractor: <br /> .3 <br /> Resteel verified: Date/Checked by: & _ i �� 7 Grade: Manufacturer: Cy_��a <br /> Supplier: w Cement(lbs/type): <br /> Mix Number: Fine Agg. (lbs): <br /> Slump Spec: Coarse Agg. (lbs/size):id _ <br /> W/C Ratio Spec: Coarse Agg. (lbs/size): <br /> Air Spec: •d,., Slag Cement(lbs): <br /> Total Yards: Fly Ash (lbs): <br /> Placed via: Water*orgal <br /> Consolidated: ( e / no )� Admixtures(specify): <br /> Required Strength (psi): <br /> Total#of Samples Cast: Total#of Field Cures: Curing Method/Location: <br /> Water C 143 C 231 C1064 <br /> Cast Samples Special Time Cubic Added Air% Cone. Ambient Truck Ticket <br /> Break Das Size Made Yards to Load Slump Test Temp Temp No. No. <br /> t /t 10 1 <br /> Weather: r. Slump Range:q t vr. Air%Range:,� <br /> Other AiIN MMU71 <br /> Inspected by: Reviewed by: <br /> (Signature) <br /> Start Time: Finish Time: <br /> This report applies only to the items tested or reported and is the exclusive 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)725-460Q or 1-888-OTTO-4-US—Fax(206)723-2221 <br /> Form No.:INSP-62-05(Rev 05/13) jr1 <br /> �s <br />