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OTTO ROSEAU& ASSOCIATES, INC. <br /> CONCRETE REPORT �. <br /> i 2 7 <br /> Job Number: _ Permit Number: <br /> .r �, . . Vis,•, � ���w�, �� <br /> Project: f) am ,�.. �� 1" Client. <br /> _ Address: <br /> Address: r°-- <br /> Inspector/Date: M �; C `? ✓ Contractor: <br /> rY_, <br /> LA 1319, 137 /3a <br /> Resteel verified: j Date/Checked by: �� ., Grade: Manufacturer: <br /> Supplier. , Cement(lbs/type): <br /> Mix Number: Fine Agg. (lbs): i <br /> Slump Spec: Coarse Agg. (lbs/size): ;. <br /> W/C Ratio Spec: Coarse Agg. (lbs/size): .Q <br /> Air Spec: •�e� Slag Cement(lbs): <br /> Total Yards: Fly Ash (lbs): <br /> Placed via: Water or gal }-lam,[ u <br /> Consolidated: ( le' / no ),j, Admixtures(specify): <br /> Required Strength(psi): O <br /> �` 5iat�► d Tesfiit>i Dato mumAM <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 Tem Temp No. No. <br /> Weather: Slump Range 4 �+ rLr'; Air% Range: �� PC <br /> t T7' <br /> Fa <br /> IX <br /> Inspected by: / + a'C \ 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 1 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 /> Form No.:INSP-62-05(Rev 05/13) "A <br />