Laserfiche WebLink
OTTO ROSE*U& ASSOCIATES, INC. <br /> CONCRETE REPORT <br /> Job Number: Permit Number: <br /> Project: P� .rG� �� r Client: <br /> Address: Address: <br /> ✓ <br /> Inspector/Date: Contractor:�� � "� • )_" ) ' <br /> rZf Pe <br /> Resteel verified: Date/Checked b : Grade: 14 0 Manufacturer: <br /> Supplier: Cement(lbs/type): <br /> Mix Number: 3 Fine Agg. (lbs): d <br /> Slump Spec: + Coarse Agg. (lbs/size):Y4 1 <br /> W/C Ratio Spec: Coarse Agg. (lbs/size): <br /> Air Spec: ! Slag Cement(lbs): <br /> Total Yards: Fly Ash (lbs): <br /> Placed via: Water-t%or gal rjv,( u �, <br /> Consolidated: (�le / no ),j, Admixtures(specify): <br /> Required Strength(psi): O <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% Conc. Ambient Truck Ticket <br /> Break Das Size Made Yards to Load Slump Test T emp Tem No. No. <br /> _ L D I A 11 - <br /> Weather /411,f rd Slump Range: "f llwf Air%Range:.,,. <br /> M ; <br /> Other A STM NMhG tlx: <br /> Inspected by: Reviewed by: <br /> —'A. (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)725-4600 or 1-888-OTTO-4-US–Fax(206)723-2221 <br /> r; <br /> Form No.:INSP-62-05(Rev 05/13) <br />