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<br /> ` OTTO ROS'LNAU& ASSOCIATES, INC.
<br /> CONCRETE REPORT 3 5 3 99 1
<br /> Job Number: !.? --ot -- Permit Number:
<br /> Project: I:- Client.
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<br /> Address: �`" c1.--..... .,,„,...4.-:-.\:--
<br /> _ -- — Address:
<br /> Inspector/Date: :-• .1..„),,,,,,,-, (L. c. ( i c.N. '" 0, Contractor:
<br /> 6 ,r'' e:7-,..<: ,- y
<br /> ."F i , L ? f t.e• '� �' a ., -jj�'L i.c�g.If, C'wt` �.i.�1 a^ tic �.
<br /> ' e t s.'' .'SatS ,„`tet b 2 .,d, i .a 2.'"7 1 ro vt .[w ..$`e_r, , ,,e%'', 0.4. ...
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<br /> t �4� � '`� tom_. k:: ,t {' 4:-..! t .` -L3 k,A,....0 � :r:c..\- , j•. ,�.�'�
<br /> '.a t jr.:4`.C.i':Li. �3' ,. � � 11/4-0 4, ill'V .'^ 4. e �LF;c_�S— � e- --2:1-72.7_ &j ic,`... i[(
<br /> Resteel verified: / , Date/Checked by: ; . . t, + Grade: -•;"T Manufacturer:
<br /> Supplier: ,p.,, 4 Cement(lbs/type): f t f t i/:',} i 6
<br /> Mix Number: F 0 ',,r';-. f,? Fine Agg. (lbs): ,,,,(,.' ,r, , +,',2
<br /> Slump Spec: 7-+ l Coarse Agg. (lbs/size): ;,'o;
<br /> W/C Ratio Spec: if' 7 Coarse Agg. (lbs/size): , ,.
<br /> Air Spec: Slag Cement(lbs):
<br /> Total Yards: 5 Fly Ash (lbs): .->
<br /> Placed via: ?.,M Water(lbs or gal): ,.
<br /> Consolidated: (,'yes''/ no ) Admixtures(specify): f
<br /> Required Strength (psi): (•.- .f,'�-"",}
<br /> ,.- ---',
<br /> Total#of Samples Cast: f--i Total#of Field Cures: — Curing Method/Location: ; f
<br /> Water C 143 C 231 C1064
<br /> Cast Samples Special Time Cubic Added Air% Conc. Ambient Truck Ticket
<br /> Break Days _ Size Made Yards to Load Slump Test Temp Temp No. No.
<br /> ^ It" .�. .7 g= 4hv FuTF r15a '� i Nm,. 2 F� 1+,K;h l °.a. n w' r eZTS'
<br /> 4 u� ° w
<br /> Weather: �_ ‘,¢. ., c Slump Range: Air
<br /> Range:
<br /> • .y,r
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<br /> s !' .-t=
<br /> Inspected by: f „.! ,o� .��" Reviewed by:
<br /> mrd f„t (Signature)
<br /> Start Time: 'P 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 /> , ' .- ':‘,\
<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) /
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