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231736_20240102_CFI_0000233006Client: Project: Technician: Date: Weather: 1471 ST RT 9 LLC 1471 ST RT 9, Lake George NY Sunny Tuesday, January 2, 2024 Brian Sweet Client Rep.:Russ Fadan Temperature: AM 32-40 °FPM Arrival Time: 3:45 PM 1:30 PM Project Number: Contractor: Contractor Rep.: 231736 J.D. Boucher Concrete Jeff Boucher Departure Time: Concrete Field Report (ASTM C31, C143, C231 or C173, C1064, C138; AASHTO T23, T119, T152 or T196, T309, T121)Page 1 of 1 3348 Route 208, Campbell Hall, NY 10916 ■ Phone: 845-496-1600 ■ Fax: 845-496-1398 12960 Commerce Lake Dr #14, Ft Myers, FL 33913 ■ Phone: 239-204-4569 1813 State Route 7, Harpursville, NY 13787 ■ Phone: 607-235-2006 877 US-4, Schuylerville, NY 12871 ■ Phone: 518-372-4067 Report Reviewed By: Jack Harrison Mix Details Supplier Strength Cylinder Type Initial Curing Method Mix Design Pallette Stone Corp, Saratoga Springs 3500 PSI @ 28 Days 4 x 8 Cylinder Curing Box 35000 Project Specifications (Provided Verbally on-site by Jeff Boucher of J.D Boucher) Structure Type Slump Slump w/MRWR Slump w/HRWR Air Content Unit Weight Mix Temp Maximum Mix Time Foundation Walls 5.00 - 7.00 in.4.0 - 7.0 % Placement Information Load Num. Truck Num. Ticket Num. Cubic Yards Total Yards Time Loaded Time Arrived Time Discharged Time Completed Slump Air Content Unit Weight Mix Temp Air Temp H20 Added Num Cyls Location 1 4525 15058 9 9 1:54 PM 2:27 PM 2:31 PM 3:02 PM 7.00 in.6.2 %62 °F 39 °F 6 North wall & 1st 15’ of west wall from the north heading south 2 4904 15059 9 18 2:23 PM 3:00 PM 3:02 PM 3:40 PM West wall from 15’ south of NW Corner & 10’ from SW Corner to the east All tests within specifications. General Location of Work: North and west foundation walls Technician Signature:Date:Tuesday, January 2, 2024 ACT-CFI-1, Rev 2, 10/13/20The results identified in this report relate only to the items sampled/tested. No representation is made that materials or items not sampled and tested will produce the same or similar results. This report shall not be reproduced, except in full, without the prior written approval of Advance Testing Company.