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OTTO ROSENA iHI ASSOCIATES, INC. <br /> ft% lrozk <br /> CONCRETE REPORT ,i;" a tilt tl <br /> Job Number: Permit Number: j OE-it) o 03/, <br /> Project: <br /> Address: 9 1 <; Ad.ress: <br /> Inspector/Date: 61 — Contractor: <br /> 1?-7 re.TAIT6'.7'4'vW-ZWF-71,-;41.'+-41 -743.3WW-T3-732 --- <br /> \ co(lc ' f,r coo ftYr 11 <br /> 7y1.: 1(\ n.,,,s 2 7 71, ZZ5 29 ar-i m_ IfAiletS <br /> ?)(1) 7 3 J <br /> - - <br /> Resteel verified: E. Date/Checked by: — 0, •r Grade: Le 0 Manufacturer: <br /> ,-..aqrfiylZi7fr:-E,..5..Ri:.;70-.5-tr-qMW.5:13MgtZZ2PFMX-iTrrMr. T3M,TEZE:;Zt:TV.TinaSq.;215Zii_17F.VW!;'; <br /> Supplier: WI Cement(lbs/type): <br /> Mix Number: . Fine Agg. (lbs): <br /> Slump Spec: r- Coarse Agg. (lbs/size): <br /> 14,10( <br /> W/C Ratio Spec: 5'7 Coarse Agg. (lbs/size): <br /> Air Spec: 11 Slag Cement(Ibs): <br /> Total Yards: ( Fly Ash (Ibs): <br /> Placed via: 9 Water(lbs or <br /> Consolidated: ( -s / no ;ifIc Admixtures(specify): <br /> Required Strength (psi): 00 <br /> S* TL141-ti <br /> Total#of Samples Cast: Him 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 Da s Size Made Yards to Load Slump Test Tern. Tern. No. No. <br /> E11111111111=1111=11=1/1/1 0 (AI :IQ <br /> 11•1111M11111 <br /> Weather: Slump Range: Air% Range:A." <br /> zFavmvwon*tPvtco'snormi,gair-=tz.ragSMMraiFtfi4FZT-SAENMfzvzat <br /> Inspected by: 7 \-, 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)725-4600 or 1-888-OTTO-4-US-Fax(206)723-2221 <br /> Form No.:INSP-62-05(Rev 05/13) <br />