Job Information
Job Information
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Document No.
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Picture(s) of delivery tickets tested
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Date Of Placement
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Customer
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Job Address
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GPS Location
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Mix #
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Ordered Slump
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Ordered Spread
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Customer Contact
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Order #
Physical Properties
Aggregate Industries Quality Control Test Results
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Batch Time
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Ticket #
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Truck #
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Test Time
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Air Content
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Slump
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Spread"
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Unit Weight (pcf)
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Yield
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Concrete Temp (F)
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Ambient Temp (F)
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Water added before test?
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Water added after test?
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Did you cast cylinders?
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Cylinder ID#?
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3 Day Break Date
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7 Day Break Date
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28 Day Break Date
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56 Day Break Date
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Additional Break Dates
Independent Test Lab Information
Independent Test Lab Information
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Picture(s) of independent test lab report
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Air content
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Slump
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Spread
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Unit Weight (pcf)
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Concrete Temp (F)
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Test Lab
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Where Cylinders Cast By Test Lab?
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Where cylinders cured according to ASTM standards? Take a picture of curing site.
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Picture of cure facility
Conclusion
Conclusion
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Additional Notes
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Additional Job Pictures
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QC Signature verifying that the information contained in this report is accurate.
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Customer Signature (if applicable)
