07-0823I
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Tel:
•:t:nv,: ntyli.r'c.com
❑ Branch 7313 Carroll Road, Suite G, San Di -00. C.A. ?2121
Tel: (556) S37-3999 Far_(a56) 5575990
❑ Branch 14=- EIssvonh SL Ste. C101, Moreno valley, CA 92553
i&_(9D9)653-4999 Fas (909) 653-=665
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FIELD DATA SHEET
REPORT OF e-oriG('2jr TESTS
PROJ_ NO: c ^ I�Z
NAME:
DATE
NOM. SIZE
(IN_)
PROD_ ADDRESS: ^ 1, `
LOAD
(LBS)
BLDGAOT NO:
TRACT NO:
BP/OSA NO: I 227
PLAN FILE NO -
FIELD LD_
LAB USE ONLY - SET NO:
DATE CAST: J ( _ U
DATE RECEIVED:
EST SCHEDULE (NO. @ AGE IN DAYS): @
C @ T DAYS, _ 2 28. DAYS, (— HOLD
DAYS, @ DAYS, @ DAYS
@ DAYS, DAYS, DAYS
MIX NO: /' 2l
SUPPLIER:
SPEC. STRENGTH:
CEMENT TYPE:
ADMIX:
TICKET NO: S�S 7 22
MIX TIME: t-( 0 / MINUTES
WATER: GALLONS ADDED c�-- BY
CAST BY: aN
SLUMP:IN.
AIR CONTENT:
%
UNIT WEIGHT:
PCF
TEMPERATURE: CONCRETE —2 �/ OF
AMBIENT:
f
OF
SAMPLE LOCATION:
REMARKS:
r FOR LAB USE ONLY Z
SET
LAB NO.
AGE
(DAYS)
DATE
NOM. SIZE
(IN_)
ACTUAL
AREA (SQ_ IN_)
LOAD
(LBS)
STRENGTH
(PSI)