Stoneleigh (Fairway)-LR 980616*40 (972) 620,89
PtViect Number 9 7 0 6 0
CUS IVaMe r-. J'S t hV o1 f � i h, e
Protect Name ,Sf 00. P le
Technician Name
"WAJ
Dale Of Pkwemwtt
Date Cyls. Recd In Lab
C6iiente Supplier
S(fcations: Slump S Air
Set
#
Concrete
St p
Ticket p
Time
Truck
Disptch'd
Tiirte
64
Molded
Time
Truck
Unloaded
Yds.
Of
Co
Unit
it
(W)
� U — p
Slump
A it 916
2
b o
��S
���
5'
le
HY t , 4- 8 -
L �ZD
��� -�
o���
C)
to
�
Not#W of any item out of Spec#icalron: Time
Signature of Pierson Noto ed X --
Item (s)
Set
#
Air
Temp.
Conc.
Temp.
Req'd
Strength
C It
Molded
placement Location of Test Sample
1
,q O,W- Q
- bO' -`�- --
- - -1-
•�
6 S"
�.r'
3ao�
�
.�
73'
�r
3 0 o n
9
-� �' �-
-s's - - - -
- -� w- - - �� �A