HomeMy WebLinkAboutSpecial Inspection Field Test & Inspection Report 2008-7-15
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MAP LOCATE
I BATCH TIME
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o Albany (541) 9282547 OCorvalhs(541) 752 3428 o Lebanon Dispatcher (541) 258 7123 OSt Helens (503) 397-Dl11 o Stayton (503) 7696465
o Angell Quarry (503) 286 1222c 0 Eugene (541) 68%600 0 Metro Central Dispatch 0 Salem (503) 390-6955
o Brownsvllle (541) 7471213 -I o Gresham (503) 666 5577 (503) 944 3550 o Sherwood (503) 692 8242
o Coffin Butte (541) 745 7572 0 Hardrock (541) 7457572 0 Relchhold r503\ 366 5900 0 Spnngfleld (541\ 747 1213
I \E~E P~NTO I f?V:.J~ ~ B7;ou~ ~ _ I Fr>;z~ I L7ES~ -I ARRIVE PLANT
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CUSTOMER ACCOUNT # 14849
JOB # BID #
. -
WATER ADDED AT TEST CYL
CUSTOMER'S REQUEST TAKEN
gals to full load 0 YES
gals to % load 0 YES
gals to 'hload 0 YES
ADDITION,AL WATER
ADDED TO THIS
CONCRETE WILL REDUCE
STRENGTH ANY
WATER ADDED IS
AT CUSTOMER'S
OWN RISK
WATER REQUESTED BY
t'
o
o
o
o
o
o
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MATERIAL
MIX DESIGN SSD
SCI1EDULED ON JOB
QUANTITY ORDERED
PREVIOUS TRUCK
1_~~1:" ..,.",...~
PRoliLJCT. #. - I
2435P270VG
24MA
~~~~
v
6 MINUTES PER YARD
FREE UNLOADING
TIME ALLOWED ON
FULL LOADS
Additional unloading
time charged at current
hourly truck rale
REASON FOR DG.LAY~TIME t.
JOB NOT READY
LACK OF HELP
WHEEL BARROW JOB
WAITING FOR TRUCK TO UNLOAD
ADDING WATER
ARRIVED JOB EARLY
OTHER
II
CODE
SOLD TO
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VERN BENSON MBI CREDIT CARD CUS
c 438 S 71ST SPRINGFIELD
DELIVERY
POINT
r' ,
07/15/08 PO #
PLANT 82 PIT
DRIVER JACK SMITH
GROSS TRUCK # 240163 TRLR #
TARE WEIGHMASTER MIKE
NET .. n. {1l(1l qc~~~IIII_ il~ '7'0
SPECIAL INSTRUCTIONS
I
-DATE
TIME
I (l{\no
MOISTURE
CORRECTION
DESIRED AMOUNT ,l ACTUAL AMOUNT
,
,
, SLUMP 5
TRIM
WATER
..
GALJYD
12:30
20.11
(35-5VO)
r ,
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/
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PRODUCT DESCRIPTION
3500 PSI @ 28 DAYS 1/2"
FIBERMESH ADDITIVE
. ~/1r:U!:lP:~ r-UE' rl_l~
TERMS NET - CASH SALES PAYABLE UPON PICKUP OR DELIVERY CHARGE SALES
DUE AND PAYABLE BY THE 15TH OF MONTH FOLLOWING PURCHASE A seMCe charge
of 1%0/0 per month or a minimum of $1 00 will be made on the unpaid balance at
the end of the following months billing cycle ThiS IS an ANNUAL PERCENTAGE RATE OF
180/0 PERSONAL NOTICE We reserve the nght to claim hen for all labor and matenal
furnished on thIS Job according to OAEGON REVISED STATUTE 87 021
SSD CORRECTED AMOUNT
'.
,.
~
WATER/
CEMENT
RATIO
~~-~~~ (
"I QUANTITY UNITS
...-:
MAXIMUM
ADD
WATER
GALS
I
,rUNIT PRICE
AMOUNT
1030.00
100.00
\
\
10.00
10.00
103.00
10.00
,
I~
1. on
1~_~?
TOTAL
r '--, J' TICKET #
RECEIVED BY
FORM 30 ReVised 7/07
3161032
responsibility for the warning In the product label regarding working with ~.rtland Cement concrete. .
CCB# 2101
J~ .. _ I
Imtlals of Acknowledger
Administrative Group (541) 926-6491 32260 Old Hwy 34 Tangent, OR 97389
ALSO SERVING YOU AT Hamsburg Prestress (541) 995 6327. Tangenl Operations (541) 928 6491
ll"$'" Information
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Address
FIELD DENSITY WORKSHEET
SOIL AND SOIL-AGGREGATE
HOURS
Prolecl No
o T HOURS
MILEAGE
S.
104D-A i;.
SpnMfleld Oregon Of."
(541)74&-S649 (M')74G-7~61lt..
Dale Per10rmed '7 - 8'- 0 k
PO 110
BP No
~
pro,' Name If...~ 0/ ,<), / / ~ /.
Prolecl Local1on ~,"f <;""n?t OJ/',, I J.. ('fY
E~ulDmenl :rroxler. . , ode'~ ~~O SNW g ~
TechniCian P r
MS" :t, r" OS "2_ V C/
Laboralorv Soil I AOClreaate Data:
. ,r, I,
MQlstLJre Den.srtv RelatlooshlD of . at % mOisture, 15 from our recort n\Jmber . dated for
MOisture Densitv R~alJOllshlP 01 al "It mOl$llJre. IS from our reoort number ' dated for
~IOlstLlre Density Rola"cn.hlp of 13..0 al ., 0,. mOl.ture, was furnlshod by <fcllenlll (oontractcr\ (suwler) .s I <t ,,\ G
. .. _ _ 1"_J - -.. ... -',. .- .-
THESE TEST RESULTS RELATE Ot<LY TO THE SP~F1'i LOCA.TIONS NOTEP.-'It<D MAY NOT REPRESENT A.NY 011lER LOCATIOt<S OR ELEVATIONS
FIeld Dens/Iv Tesf Results: I.... { Dr. Y c c/
. Te$lNo . ,r. ~PPROXlMA~~TESTLOCATl~~~ I t... - ':PAOKlMATE ...( PROSE ~ WETDENsm -- DRYDE<<s.~n j:)ERC"ENT
TESfElEV DEPTH LBsrcU FT LBSfCU FT MOlSlURE
rests pertormed at llJ!1j'hed orade) (belovrftmshe,Jgraue) "l ti>~:'n "":1,) lill maten.!} (trench backf~l) (c\her)
Te,t ,,,"ullswere ve<bally,eponed 10 \/ <:- YVl /0 lJJ h e- y-
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PEHCHIT
COMPACTION
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THlSR.:'""fOfirIS PRDV1DEOFOIl TH.EJII,\"'OAId.4.l1WI OF THE CLlEllt ON.lY mE REPROOUt::"flD,IIOF rnT5 R5<'0RTBY "'rY~~n5~,tL ro..c. ni'RD PARTY 9't AMY&1EA.HSEXGe'TINf\.A.lISPRo.'il.BI'1EO
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