| Sample Information | |||||
| Sample ID | 20060115-0007 | Sample Date | 04/15/2006 | Sampled By | James Doe |
| Sample From | Concrete truck | Sample Origin | Sample Size | 75.00 CY | |
| Sample Type | Project Acceptance | Acceptance Method | Certified Test Report | Sample Status | Testing Complete |
| Material | Concrete, Class A (CONC-A) | ||
| Producer/Supplier | Ready Mix Concrete, Inc. | ||
| Brand Name | Acme | ||
| Manufacturer | Ready Mix Concrete, Inc. | ||
| Intended Use | Concrete for shell piles bent 3 | ||
| Buy USA | Yes | Requirement Type | USA |
| Mix Design Type | Aggregate | Mix ID | B423 |
| Plant | Southwest 34th Street Plant | ||
| Control Number | 42 | Control Type | Lot Number |
| Geographical Area | Region 1 | Reference Document | April 2006 Book 7 |
| Logged By | James Doe | Log Date | 04/15/2006 |
| Requested By | Jill Adams | Witnessed By | Jill Adams |
| Authorized By | Jill Adams | Authorized Date | 04/16/2006 |
| Remarks | |
| Type | Description |
| general | Trimmy tube used to place concrete. |
| Test Information | |||||||
| Test Method | Test Description | Test Number | Lab ID | Tested By | Start Date | Completion Date | Test Status |
| AT-17 | Air Test | 1 | 24 | James Doe | 04/15/2006 | 04/15/2006 | Approved |
| ST-2 | Slump Test | 2 | 24 | James Doe | 04/15/2006 | 04/15/2006 | Approved |
| YT-24 | Yield Test | 3 | 24 | James Doe | 04/15/2006 | 04/15/2006 | Approved |
| Pay Item Information | |||||||
| Contract | Project | Group | Seq # | Item | Represented Quantity | Material Unit | |
| B14-3349 | F23B-14003 | 1 | 00090 | 500-3101 - Class A Concrete | 75.000 | CY | |
| B14-3349 | F23B-14003 | 2 | 00190 | 500-3101 - Class A Concrete | 75.000 | CY | |