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OTTO RaS1'NAU& ASSOCIATES INC. <br /> CONCRETE REPORT 3 5 3 9 9 1 <br /> Lanagamorminir Permit Number: <br /> "-. <br /> Project: Client: <br /> Address: Address: <br /> Inspector/Date: - (L., CR IMITIM.Contractor: <br /> , \r -s• e 'e <br /> I r:1/44, 2:7 e:7 <br /> MEMEMEMIMMISEINEEMEMBEERENERIMI <br /> p, • <br /> va-ik <br /> Resteel verified: )0Le.e. Date/Checked by: 9 mgE!Emm Grade: 1. Manufacturer: <br /> Supplier: Cement(lbs/type): t tit til ) (1 <br /> Mix Number: I r Fine Agg. (lbs): ( <br /> Slump Spec: Coarse Agg. (lbs/size): 7/er <br /> W/C Ratio Spec: e" -7 Coarse Agg. (lbs/size): <br /> Air Spec: Slag Cement(lbs): <br /> Total Yards: Fly Ash(lbs): &t) <br /> Placed via: Water(lbs or gal): r ei e <br /> Consolidated: (Nes / no ) Admixtures(specify): <br /> Required Strength(psi): I- <br /> Total#of Samples Cast: L-t Total#of Field Cures: Curing Method/Location: p) <br /> ' - <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 Tem. Tern. No. No. <br /> , <br /> ralpi <br /> -7/: • <br /> IFTM174' <br /> Weather: L. ,t7ç Slump Range: ••::" Air% Range: <br /> .,"•<•. <br /> Inspected by: -^" <br /> Reviewed by: <br /> ,/e./ <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 />