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OTTO RUSENAU& ASSOCIATES, INC. <br /> CONCRETE REPORT <br /> Job Number: _ Permit Number: '�;..u!-s 2 c • - ; •'F ter..''..,! <br /> _ . <br /> < "' <br /> Project: -. ; Client: <br /> . L i' <br /> Address ,. , Address: <br /> `i_1 . <br /> - •e(.. 4� <br /> AW'/' <br /> 3 ..:t .Y i j.j ,S ( at 4 <br /> Inspector/Date: -• Contractor: <br /> DESCRIPTION/LOCATION . (. , <br /> -- <br /> - 4 / + • <br /> ill r.,5/_;('(T79 72(- ! Pi/-l4.3 0( 41.E j i i.' . =+ .,:t' <br /> 1 ( 1_z.L; ; (,/ C) ,' d.#4F 2..) ---i.4: . <br /> Resteel verified: Date/Checked by: Grade: Manufacturer: <br /> Placement Data Batch Weights per cu yd.-Please circle Design I Actual <br /> Supplier: f''„.i/C�) ,r J Cement(lbs/type): <br /> Mix Number: /1 2.5 6 '/2 Fine Agg. (lbs): i5;., C <br /> Slump Spec: (.1'',..,: r r Coarse Agg. (lbs/size): ' , , <br /> W/C Ratio Spec: Coarse Agg. lbs/size 1 !�: ,f i <br /> cr <br /> Air Spec: 1 ,,I Slag Cement(lbs): <br /> Total Yards: ....310 Fly Ash (lbs): 6111 <br /> Placed via: 7 + �-- <br /> - ' `I Water(lbs or gal): <br /> r''lil rkLjc.-, .-5 r_i <br /> Consolidated: ("( yes;:./ no ) Admixtures (specify): i y1 Il <br /> Required Strength (psi): r f <br /> Sam. pliiti and T Data(ASW C17Z-cinf;_ _ . <br /> Total#of Samples Cast: Total#of Field Cures: Curing Method/Location: ,,, ,, -/7-:.,,:l.) - <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 TempTemp No. No. <br /> Weather: _ _ • Slump Range: Air% Range: <br /> _z c, r--v. <br /> Comments <br /> Other ASTM Methods.Used: Conforms Does Not Conform <br /> Inspected by: LAL4 _ +• (•t-.t,.&.z Reviewed by: <br /> (Signature) <br /> Start Time: ,I.,).Li:r,/f 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 'I', of ../7-"----. <br /> = - <br /> f <br /> 6747 M.L. King Way S.,Seattle,Washington 98118-Phone(206)725-4600 or 1-888-OTTO-4-US-Fax(206)723-2221 4 <br /> Form No.:INSP-62-05(Rev 05/13) k <br />