P.C. Concrete Strengths I.D. Number (1): Inspector No Date Reported Sequence No County (2): (3): (4): (5): Type Insp Total Samples 01 Section: (6): (7): Prod. No Prod. Name Route: (8): (9): Matl. Code Name District: (10): (11): Desc. 1 Copy Resp. Loc Contract No: (12): (13): (14): Lab Lab Name Compl. Date Test Results Job No: (15): (16): (17): (18): Remarks Project: (19): Assign Y Contract Job No City: (20): (21): (22): Type C Days or Strength Strength Strength Average Strength Strength Strength Average Type Const. Date Cast Series Age Age Design or F Hours psi psi psi psi psi psi psi psi (23): (27): (28): (30): (31): (32): (33): (35): (36): (37): (38): (24): (25): (26): (29): (34): Remarks (39): Remarks Remarks Remarks Remarks Remarks Remarks Remarks Reported By Remarks Copies To (40): (41): (42): (Printed Name and Signature are required) Tester Agency C (43): (44): (45): (Printed Name and Signature are required) MISTIC INPUT /FOR DTY0300 Date Entered (46): Initials (47):
P.C. Concrete Strengths I.D. Number (1): Inspector No (3): Date Reported (4): Sequence No (5): County (2): Type Insp (6): Total Samples (7): 01 Section: Prod. No (8): Prod. Name (9): Route: Matl. Code (10): Name (11): District: Desc. 1 (12): Copy (13): Resp. Loc (14): Contract No: Lab (15): Lab Name (16): Compl. Date (17): Test Results (18): Job No: Remarks (19): Project: Assign (20): Y Contract (21): Job No (22): City: Design (23): Type Const. (24): Date Cast (25): Series (26): Type C or F (27): Days or Hours (28): Age (29): Strength psi (30): Strength psi (31): Strength psi (32): Average psi (33): Age (34): Strength psi (35): Strength psi (36): Strength psi (37): Average psi (38): Remarks (39): Remarks Remarks Remarks Remarks Remarks Remarks Remarks Reported By (40): Remarks (41): Copies To (42): (Printed Name and Signature are required) Tester (43): Agency (44): C (45): (Printed Name and Signature are required) MISTIC INPUT /FOR DTY0300 Date Entered (46): Initials (47):
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