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OTTO ROSENAU& ASSOCIATES, INC.
<br /> 307
<br /> CONCRETE REPORT
<br /> Job Number: Permit Number:
<br /> Project:`a rya ' , y '_ + Client •
<br /> Jefrfv�s 1 74 L ,
<br /> Address:<',f 3 ,-4,ryAddress: 1 3
<br /> 1 -, ,r L. `.,Q .V.1 k J'C,.. ,�., i--- a of r.. ,, --1:, Address:
<br /> Inspector/Date: .r7 f y 1-. --'- / -+ ,, , _: Contractor: c
<br /> DESCRIPTION/LOCATION g r
<br /> ✓1 St9 �~ iI Co ri C.IT_Cr l i f'd qt.ri,-,,s,$1 + ,. O$!{ i f . 7 d`47,r.;j u i! f, J
<br /> Z -1 r, s '-- 1^,J.1 (/ 2 4 0 St-to c i ?le"0 i e' °- (-19 .t;q i! S 2 , 'CK: . i'.4.-
<br /> 1140 ill f)i.\1 }^ 1[.".( '.`,1i^(/ S-17 6. 7c, ril;i ( f i J 4-S pi f,4
<br /> Resteel verified: (2 Date/Checked by: ,-, , c‘,.. f (* i— Grade: Manufacturer: /7-,
<br /> q'
<br /> MillillEr Placement Data Batch Weights per cu.yd.-Please circle Design / Actual
<br /> Supplier: .T lc m Cement(lbs/type): :110 1-",..,. / L
<br /> Mix Number: / S ,Z 0 .T., j_ Fine Agg. (lbs): /i.,..(4.,i0
<br /> Slump Spec: 9 ei,/ _Coarse Agg. (lbs/size): `/Z-7,-, , rf
<br /> W/C Ratio Spec: Q, -; Coarse Agg. (lbs/size): -, ,0 ,
<br /> ,,---Air Spec: Slag Cement(lbs):
<br /> • total Yards: 90
<br /> I,- Fly Ash(lbs): 6
<br /> Placed via: r`.1 7)-1 ,� -1- LA__ , Water(lbs or gal): t,�„t
<br /> Consolidated: 1 ( yes) no ) Admixtures(specify): t.1
<br /> Required Strength (psi): 2 ,,-,,Yti,`- f 7S'
<br /> ' Sampling and Testing Data(ASTM C172,C31)
<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 Days Size Made Yards to Load Slump Test Temp Temp No. No.
<br /> I : <X L_--) . iA ' - c-0
<br /> r
<br /> Weather: Slump Range: Air% Range:
<br /> Comments
<br /> Other ASTMMeths;Used: Conforms Does Not Conform
<br /> ,'
<br /> Inspected by: 1".'-'f AL, ,.- ' i-',4_:.-1" .,.- Reviewed by:
<br /> (Signature)
<br /> ,- Start Time: +., Finish Time:
<br /> ),
<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 frdm our firm is strictly prohibited.
<br /> Page of L7/
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<br /> 6747 M.L. King Way S. Seattle,Washington 98118-Phone(206)725-4600 or 1-888-OTTO-4-US-Fax(206)723-2221 7
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<br /> Form No.:INSP-62-05(Rev 05/13)
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