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4BEACH BOULEVARD C
Pi N G Il E E R I G, INC, JAGKS{MIV{LLE,FL 32216 Pro
t 904-721-1100 OFFICE jest No.:
904-722-1100 FAX No
GeotechnicOl&Materials Engineering and Testing page
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Lab No.
R gout of In-Place Densi (Asphalt o o 'eats or Coring for Thicknew(--circle one--)
Project: "
Contractor: `- thod:
Reported To: rpeation by:
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Material` .
f Spec. Requtrements•
Date
Pass/ Location Elev/ Base/L Dry "Max: %of Moist
Fail/ p Asphal Density Thi' Max
Retest t ift Thickness Density* Den
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*Source of Procter(Project Number}
P`-test Meets Specification Requirements F-Test Fails To Meet Specification Requirements R Retest
Io BiC-0m*kd In Field
Employee Name o-Standby Time frdm to Total:
Billing Comt*ents O-Job Time frgrn to Total:
Tripe(Job Canceled) from to Total
Char O-Travel Time
(Toi�I
. Out of Town Mobilization o-Travel Time fr¢m to Total:
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Total How-s:
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