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    1.0 CIV-FRM-001-06-01 Test Request Form For Concrete

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    Jestin Daniel James
    The document is a test request form for concrete samples from a construction project. It provides details on the project, samples taken on specific dates from different concrete batches, and the tests requested to be performed on set dates including compressive strength tests at 7 and 28 days. The form requests information on the sample source and testing standards to be followed.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    1.0 CIV-FRM-001-06-01 Test Request Form For Concrete

    Uploaded by

    Jestin Daniel James
    2 views1 page
    The document is a test request form for concrete samples from a construction project. It provides details on the project, samples taken on specific dates from different concrete batches, and the tests requested to be performed on set dates including compressive strength tests at 7 and 28 days. The form requests information on the sample source and testing standards to be followed.

    Original Description:

    Grout test request

    Original Title

    1.0 CIV-FRM-001-06-01 Test Request Form for Concrete

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    © © All Rights Reserved

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    The document is a test request form for concrete samples from a construction project. It provides details on the project, samples taken on specific dates from different concrete batches, and the tests requested to be performed on set dates including compressive strength tests at 7 and 28 days. The form requests information on the sample source and testing standards to be followed.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    2 views1 page

    1.0 CIV-FRM-001-06-01 Test Request Form For Concrete

    Uploaded by

    Jestin Daniel James
    The document is a test request form for concrete samples from a construction project. It provides details on the project, samples taken on specific dates from different concrete batches, and the tests requested to be performed on set dates including compressive strength tests at 7 and 28 days. The form requests information on the sample source and testing standards to be followed.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Issue #

    TEST REQUEST FORM FOR CONCRETE 01

    Rev. #

    06

    Customer / Contractor AUTOMECH ENGINEERING CO

    NA
    Consultant
    EGA-ATA REFINERY
    Client / Owner
    Project Name THIRD BALL MILL

    CM2219
    Project Number
    EGA AL-TAWEELAH
    Project Location

    02.04.2024, 03.04.2024, 04.04.2024 02.00PM, 03.00PM, CUBES


    Sampling Date Time 02.30PM # of Cube/ Cylinder
    Sampled By □ Customer □ Consultant □ Lab Technician
    Name of Person ABDUL
    Sampling Cert. Ref.
    Making Cube/ Cylinder
    100*100*100
    Size of the Sample Place of Sampling
    Source of Concrete SIKA GROUT Equipment Used Tamping Rod / Vibrator
    Place of Making Cube/
    EGA AL-TAWEELAH,THIRD BALL MILL Compaction Method Manual / Vibration
    Cylinder
    Class of concrete / Grout-Master flow 648, Nominal Size (mm)
    Specified strength Grout-Master flow 928
    Site Curing Condition □ BS 1881 P111: 83 (Amd 9387/97) □ BS EN 12390: 2009 Part 2
    Sampling Method □ BS 1881 P101: 83 (Amd 6728/91) □ BS EN 12350: 2009 Part 1
    Sample Description
    REQ.
    CUBE DATE OF
    STRUCTURE REF. TEST REQUIRED DATE OF TEST TEST
    NO. CAST AGE
    1 Grout-Master flow 928 Batch no: 1000944267 09.04.2024[7th day] 02.04.2024
    2 Grout-Master flow 928 Batch no: 1000944267 30.04.2024[28th day] 02.04.2024
    Grout-Master flow 648 Part A:1000956639 Part B:1000956344,
    3 Part C: M000973507
    10.04.2024[7th day] 03.04.2024
    Grout-Master flow 648 Part A:1000956639 Part B:1000956344,
    4 Part C: M000973507 01.05.2024[28th day] 03.04.2024
    Grout-Master flow 648 Part A:1000956639 Part B:1000956344,
    5 Part C: M000973507
    11.04.2024[7th day] 04.04.2024
    Grout-Master flow 648 Part A:1000956639 Part B:1000956344,
    6 Part C: M000973507 02.05.2024[28th day] 04.04.2024

    Test Method: BS 1881 P 114/ 116/ 120/ 122/ 124/ 208, ASTM C 39/C 39 M / C 78/ C 109/C 109 M /C 1202
    AASHTO T 277, BSEN 12390 P3/8, DIN 1048, RILEM CPC 11.3.

    Requested By Signature

    Tel # Fax # PO Box #

    OFFICE USE ONLY


    Condition of Specimen
    Sample Provided By □ Customer □ Consultant □ Client / Owner
    Sample Accepted By Date Received Time
    Request # Sample # Job #

    Distribution : White – Section, Yellow – Stores, Pink - Client

    Form Ref.: CIV-FRM-001-06-Test Request Form for Concrete

    THIS DOCUMENT SHALL NOT BE REPRODUCED IN PART OR FULL WITHOUT THE EXPRESS PERMISSION OF LONESTAR

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