Concrete placement in perimeter footings Special InspectionOTTO ROSENAU & ASSOCIATES, INC.
CONCRETE REPORT 415421
Job Number:
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Permit Number: - — -
Project:
.1
Client.
Address: <
Address:
Inspector/Date:
Contractor: r
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t:
Resteol verified: Date/Checked by: w 1 Grade: Manufacturer:
Placemeit Data
Supplier:
-
- _
- ' Be#eh Wei hts er ce d ;Please circle _-Desi n)1 Actual
Cement (ibs/t e): !, r a
Mix Number: t'rnl�; f.j
Fine Agg. (Ibs):
tl�rr
Slump Spec: r <
Coarse Agg. (Ibs/size):
WIC Ratio Spec: , ;
Coarse Agg. (Ibs/size):
Air Spec:
Slag Cement (Ibs):
Total Yards:
Fly Ash (lbs):
Placed via 1
Water (Ibs or gal):
Consolidated: { ;yes 1' no }
Admixtures (specify): i
Required Strength (psi): �,.,;� 2 '•
:`Sari
Total # of Samples Cast. ;r�
Total #>` of Fiefd Cures
Curing Method/Location.
Cast Samples
Special
Time
Cubic
Water
Added
C 143
c
Aionc.
Ambient
Truck
Ticket
Break Da s
Size
Made
Yards
to Load
Slump
4231C1064
Tem
Te/m
No.
No.
��
�J'
Weather ti t ,,,• Slump Rango: ,r i? Air %Range: r
:fc
.1
Comments
�..�,rr� H m m noas vseu:I Conform X Doffs pia#Eon€or.
Inspected by: Reviewed by:
' (Signature)
Start Time: Finish Time:
This report applies only to the items tested or reported and is the exclusive property of Otto Rosenau & Associates Inc. Reproduction of this report.
except in full, without written permission from our firm is strictly prohibited.
Page of
6747 M L King Way S , Seattle, Washington 98118 - Phone (206) 725-4600 or 1-888-OTTO-4-US - Fax (206) 723-2221
Farm No.: INSP-62-05(Rev 05113)