Quality Assurance Nuclear Density Report QC/QA I.D. No. Inspector No. Date Sampled Seq. No. County Bit Mix Bit Mix Code Section Plant Contract No. Job No. Target Dens. Route Respons. Loc. Lab Standard Count Project Start Complete Date Data Date Gauge Calib. Date M= # Mode Probe Depth B= Date Lift No. Lit d Big D Type Den Laid Station Ref (Thick) (Gmb) (Gmm) % Den Result Insp Kg/m3 Lot 1 2 3 4 5 REMARKS 1 2 3 4 5 Test No. 1 2 3 4 5 Offset CR kg/m3 Count kg/m3 Count CR kg/m3 CR Average Tester Inspector MISTIC INPUT Date Entered Initials DTY03303’ ‘FOR
Quality Assurance Nuclear Density Report QC/QA I.D. No. Inspector No. Date Sampled Seq. No. County Bit Mix Plant Bit Mix Code Section Contract No. Job No. Target Dens. Route Respons. Loc. Lab Standard Count Project Start Date Complete Date Data Gauge # Calib. Date M= Mode Probe Depth B= Date Laid Station Ref Lift No. (Thick) Lit d (Gmb) Big D (Gmm) % Den Result Type Insp Den Kg/m3 Lot 1 2 3 4 5 REMARKS 1 2 3 4 5 Test No. 1 2 3 4 5 Offset CR kg/m3 Count kg/m3 Count CR kg/m3 CR Average Tester Inspector MISTIC INPUT Date Entered Initials ‘FOR DTY03303’
BMPR%20MI303N.docx