CF-Police/Ct Lot-LR 990105 Maxim Tech. · Southwestern Labs
2575 Lone Star Dr. · P.O. Box 224227
Dallas, Texas 75222
T E C H N O L O G I E S I N C Telephone: (214) 631-2700
FAX: (214) 920-1891
IN-PLACE DENSITY TEST SERVICE ORDER
Client: Client No.:
Report No.:
Project: i'~'¢ ~ 0 ~ \ ~5 ()TO ~, vx ~ '~"~ ~ t~ [c'lDate °f service: I- 5'
Contractor: Page / of
REQUIREMENTS
Density: ASTM D-2922 q ~ Gauge Manuf. & Model:
Moisture: ASTMD-3017 (~) /4 Gauge Serial No. :
Density Standard Counts Current: ~._ ~.._~ (.~, Moisture Standard Counts Current:
Density Standard Counts Previous: ~Z. 'fi~ (.o ~ Moisture Standard Counts Previous: ~o 74 -:~
Test Mode (DT / BS): .1~-~"~ Probe Depth' 0, 2,(4~, 6, 8, 10, 12 Circle One
MOISTURE / DENSITY RELATIONS
M/D Test Report Material Optimum Maximum
No.: of Number Description Moisture Densi~
IN-PLACE DENSITY TESTS
Test Test M/D Moisture Density Percent
No. Location No. Content pcf Compaction
-' A ~ ~ ~5~ ',ii~,,~ '~ ~C ~'2,
lbs wet
lbs wet
% d~ %
lbs wet
% d~ %
lbs wet
lbs wet
% d~ %
lbs wet
lbs wet
% d~ %
Rem~ks:
Technician: ~-_~ ]~_(> :~ Client Rep. :
Time Start: Stop: Contractor Notified of Results CY / N)? 7
~0?.r le~ers .apd re0orts ~e for ~e ..excl.u~.*ve use of_the client .to w~om they are addressed and shaft not be reoroduced except in
~L~onn~..ut.~e.h_~O_p[o_._v~._o~ ~_e.zes.~.n,~ ~u=or_at~o_ry~. ln.e use or 0umame must recave our .wnnen approval. Our leViers and reDorts