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Rubble Concrete

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Hazel Tago Manumba
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122 views1 page

Rubble Concrete

Uploaded by

Hazel Tago Manumba
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Department of Public Works and Highways Issue Date: February 7, 2023

DAVAO DEL SUR Doc. Code DPWH-QMSF-19/20


DISTRICT ENGINEERING OFFICE
REGIONAL OFFICE XI Revision No. 1
Digos City, Davao del Sur
Construction Materials Testing
SAMPLE CARD Page No. Page 1 of 1

PROJECT INFORMATION:
Proposed Use: Informational/Research DPWH/other Government Project

For Informational/Research: For DPWH/other Government Project:


Company/ Requesting Entity: Project Name : Construction of Digos River Flood Control Project,
Brgy. Ruparan (Section 2), Digos City, Davao del Sur
Supplier : N/A

Contract I.D. No. : 22L0-0084


Implementing Office : DPWH Regional Office XI
Bill Charge To : N/A Contractor : P.L. Sebastian Construction, Inc.
Address : N/A Supplier : P.L. Sebastian Construction, Inc.
Bill Charge To/ : P.L. Sebastian Construction, Inc.
Address Sitio Calumpang, Inawayan, Sta. Cruz, Davao del Sur
TIN : N/A TIN : 276-267-621-000
Contact No/s. : N/A Contact No/s. : 0915-183-2737

SAMPLE INFORMATION:
Kind of Material : Concrete Cylinder Samples Original Source : P.L. Sebastian Construction, Inc.
Brand : N/A Type/Grade/Class : Class B - Structural Concrete

Sample Identification : RC - CCS - 01 Quantity Represented : STA.1569+000 - STA. 1569+060 R/S

Sampled at/ Address : Jobsite/ Ruparan, Digos, Davao del Sur


Manufacturer/Address : P.L. Sebastian Construction, Inc./ Ruparan, Digos, Davao del Sur
Manufacturing Date : February 22, 2024 Batch Identification No. : N/A

TEST INFORMATION:
Test Desired : Compressive Strength Test
Proposed Use : Item 1713(1) - RUBBLE CONCRETE
Governing Spec's : (16.5 mpa/2400 psi @ 28 days)
Sampled by : IAN D. BARRIENTOS & HAZEL T. MANUMBA
(DPWH Materials-In-Charge and
(Signature)
Supplier's/ Contractor's Authorized Representative)
DPWH R.O. XI & P.L. SEBASTIAN
LAB. TECH. & FIELD ENGINEER CONSTRUCTION, INC.
February 22, 2024

(Designation) (Office) (Date)


Submitted by : GREG MATTHEW D. YEE & EMMANUEL D. LACABA
(DPWH Materials-In-Charge and
(Signature)
Supplier's/ Contractor's Authorized Representative)
DPWH R.O. XI & P.L. SEBASTIAN
MATERIALS ENGINEER & MATERIALS ENGINEER
CONSTRUCTION, INC.

(Designation) (Office)
REMARKS :

NOTE: Fill out all the necesarry information. Put N/A if not applicable

Checked/Reviewed by/Date : Date OR Presented :


Date Submitted/Received by : Approved for Testing by/Date :
OR No./Date/Amount : Target Date of Release :
Lab. No. :

NOTED:

NICOMEDES D. PARILLA, JR.


DISTRICT ENGINEER

Sample and Date Submitted :


Lab. No. and OR No. :
Target Date of Release :
Contact No/s. :
Note: You will be notified accordingly should there (In-Charge of Materials Testing)
be a delay in the release of test report DPWH DAVAO DEL SUR DEO

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