CONCRETE MIXTURE DESIGN SUBMITTAL Version 3.

14
Contract Number Pin Number Project Ref. No.

Plant Producer/ Location 0 Plant Number 0

Contractor Class of Concrete 0 Req'd Strength 3000 psi @ 28 DAYS Early Strength 3000 psi @ 18 HOURS

P/S Code Cementitious Materials (cm) Type/Grade Source Gravity Weight, lbs. Volume, ft3
0 Cement 0 0
0 Flyash 0 0
0 GGBFS 0 0

0.0
P/S Code Aggregates Type/Size Source GS (SSD) Weight Volume
0 Coarse Aggregate 1 (CA1) 0 0
0 Coarse Aggregate 2 (CA2) 0 0
0 Coarse Aggregate 3 (CA3) 0 0
0 Fine Aggregate 1 (FA1) 0 0
0 Fine Aggregate 2 (FA2) 0 #REF!
Brand Name Source % Air Weight Volume
0 918.09.011 Air-Entraining Admixture
0 0 ---
918.01.001 Water w/cm = #VALUE! 0 1 0.0 0.000
.
P/S Code Chemical and Other Admixtures Brand Name Source Design Parameters
0 918.09.012 Water Reducer 0 0 Total cm Weight, lbs.
0 918.09.013 Retarder 0 0 Total Aggregate Volume, ft3
0 918.09.014 Accelerator 0 0 %FA of Total Agg. Vol.
0 918.09.015 Water Reducer/Retarder 0 0 Theoretical Unit Wt., pcf #DIV/0!
0 918.09.016 Water Reducer/Accelerator 0 0 Freshly-Mixed Properties
0 918.09.017 High-Range Water Reducer 0 0 Air Content, %
0 918.09.018 High-Range Water Reducer/Retarder 0 0 Temperature, F
0 918.09.024 Misc Admixtures for Concrete 1 0 0 Slump, in.
0 918.09.024 Misc Admixtures for Concrete 2 0 0 Unit Weight, pcf
0 918.09.022 Type S Admixtures 0 0 Yield 0.0
0 918.09.023 Precast 0 0

AGGREGATE DATA
CA/FA 4" 3-1/2" 3" 2-1/2" 2" 1-1/2" 1" 3/4" 1/2" 3/8" No. 4 No. 8 No. 16 No. 30 No. 50 No. 100 No. 200 FM Absorption
CA1 ---
CA2 ---
CA3 ---
FA1 10.00
FA2 10.00

COMPRESSIVE STRENGTH DATA

Sample No. Date Made Date Tested Age, days Length, in. Diam., in. L/D C Area, in2 Load, lbs. Strength, psi Average, psi
0 #DIV/0! 0.00 #DIV/0!
0 #DIV/0! 0.00 #DIV/0! #DIV/0!
0 #DIV/0! 0.00 #DIV/0!
0 #DIV/0! 0.00 #DIV/0!
0 #DIV/0! 0.00 #DIV/0! #DIV/0!
0 #DIV/0! 0.00 #DIV/0!
0 #DIV/0! 0.00 #DIV/0!
0 #DIV/0! 0.00 #DIV/0! #DIV/0!
0 #DIV/0! 0.00 #DIV/0!

Remarks: Mix ID:

Technician Name: Certification Number:

 CONCRETE MIXTURE DESIGN S
Contract Number CNL 999 Project Number 123-45-6789

Producer JHG Concrete Inc. Plant Location Nashville, T

Contractor Bell & Associates Class of Concrete A

P/S Code Cementitious Materials (cm) Type/Grade Sourc

Cement I/II Cemex - Nas
Flyash F SEFA Group - Cu
GGBFS

P/S Code Aggregates Type Size S

Coarse Aggregate 1 (CA1) Limestone #57 Rogers Group
Coarse Aggregate 2 (CA2)
Coarse Aggregate 3 (CA3)
Fine Aggregate 1 (FA1) Natural Rogers Group
Fine Aggregate 2 (FA2)
Brand Name S
Air-Entraining Admixture
BASF M
Water w/cm = 0.45

P/S Code Chemical and Other Admixtures Brand Name S

Water Reducer BASF Poly
Retarder
Accelerator BASF Polyh
Water Reducer/Retarder
Water Reducer/Accelerator
High-Range Water Reducer
High-Range Water Reducer/Retarder
Fibers
Lithium Nitrate
Corrosion Inhibitor
Coloring

AGGREGATE DATA
CA/FA 4" 3-1/2" 3" 2-1/2" 2" 1-1/2" 1" 3/4" 1/2"
CA1 100 96 90 54
CA2
CA3
FA1 100 100 100 100 100 100 100
FA2

COMPRESSIVE STRENGTH D
Sample No. Date Made Date Tested Age, days Length, in. Diam., in.
1 2/1/12 0:00 2/8/12 0:00 7 12.00 6.00
2 2/1/12 0:00 2/8/12 0:00 7 12.00 6.00
 3 2/1/12 0:00 2/15/12 0:00 14 12.00 6.00
4 2/1/12 0:00 2/15/12 0:00 14 12.00 6.00
5 2/1/12 0:00 2/29/12 0:00 28 12.00 6.00
6 2/1/12 0:00 2/29/12 0:00 28 12.00 6.00
0
0
0

Remarks: NA

Technician Name: James Gordon

E MIXTURE DESIGN SUBMITTAL
45-6789 Project Ref. No. BRST-HE-9(54)

Nashville, TN Plant Number 25

A Req'd Compressive Strength 3000 psi @ 28 days

Source Gravity Weight, lbs. Volume, ft3

Cemex - Nashville, TN 3.15 452.0 2.300
SEFA Group - Cumberland City 2.40 112.0 0.748

Source GS (SSD) Weight Volume

Rogers Group - Murfreesboro, TN 2.73 1825.0 10.713

Rogers Group - Mufreesboro, TN 2.70 1341.0 7.959

Source % Air Weight Volume

Micro-Air 6.0 --- 1.620
--- 1 252.0 4.038

Source Design Parameters

Polyheed 1025 Total cm Weight, lbs. 564.0
Total Aggregate Volume, ft3 18.673
Polyheed NC534 %FA of Total Agg. Vol. 42.6263007325
Theoretical Unit Wt., pcf 145.4431736728
Freshly-Mixed Properties
Air Content, % 6.7
Temperature, F 80.0
Slump, in. 4.0
Unit Weight, pcf 145.40
Yield 27.2

AGGREGATE DATA
3/8" No. 4 No. 8 No. 16 No. 30 No. 50 No. 100 No. 200 FM Absorption
33 5 3 --- 4.0
---
---
100 96 90 71 50 25 8 2.0 2.60 1.0
10.00

MPRESSIVE STRENGTH DATA

Diam., in. L/D C Area, in2 Load, lbs. Strength, psi Average, psi
6.00 2.00 1.00 28.27 111401 3940
6.00 2.00 1.00 28.27 114228 4040 4177
 4177
6.00 2.00 1.00 28.27 128648 4550
6.00 2.00 1.00 28.27 132607 4690
6.00 2.00 1.00 28.27 166253 5880 5443
6.00 2.00 1.00 28.27 162860 5760
0.00 #DIV/0!
0.00 #DIV/0! #DIV/0!
0.00 #DIV/0!

Certification Number: 8099

 CONCRETE MIX DESIGN CHECKLIST

CONTRACT INFORMATION
Contract
Letting Date
Region
Project No.
Ref. No.
County
Project Manager
Contractor
Same as design contract
Lbs. of cement correct
Certified Concrete Mix Design technican
Certification number

GENERAL CONCRETE INFORMATION

Concrete
Contractor's mix design provided
Class of concrete
Class of flyash
Compressive strength requirements
Compressive strength test results provided
Water/cement ratio is acceptable
Proportion of fines is acceptable
Design air is correct

CEMENTITIOUS MATERIALS
Cement Fly Ash
Source specified Source specified
Product on QPL 15 Product on QPL 16
Certification from producer provided Certification from producer provided
Certified mill test report provided Certified lab test results provided
specific gravity specific gravity

AGGREGATES
Coarse Aggregates Fine Aggregates
Source specified Source specified
Source is approved Source is approved
Lab test results provided Lab test results provided
gradation Gradation
specific gravity Specific gravity
Fineness Modulus

ADMIXTURES
Sources and brands specified
Products on QPL 4

TECHNICIAN NAME: CERTIFICATION NUMBER: