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Sample Card EB Testing 2023 23GG0081

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Jezreel Flotilde
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0% found this document useful (0 votes)
30 views10 pages

Sample Card EB Testing 2023 23GG0081

Uploaded by

Jezreel Flotilde
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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DPWH-BRS

E.B. TESTING CENTER, INC. ACCREDITED


MATERIALS TESTING AND GEOTECHNICAL ENGINEERING LABORATORY

NO. 18 R. Mapa Street, Manduriao, Iloilo City, Philippines


Telefax No.: (033) 321-1321 ; Tel No. (033) 328-3884, Contact No.:09253000772 VALID UNTIL
email : [email protected] April-19

SAMPLE CARD

PROJECT : 23GG0081 PREVENTIVE MAINTENANCE OF ROAD: ASPHALT OVERLAY


ILOILO CITY-LEGANES- DUMANGAS COASTAL ROAD
(Name) (City/Province)
KIND OF MATERIAL : ASPHALT MIX
SAMPLE IDENTIFICATION : AM-01, AM-02
QUANTITY REPRESENTED : 130 T
SAMPLED AT : Jobsite
(Give Accurate Location if Possible)

ORIGINAL SOURCE : Pavia Asphalt Batching Plant


OWNER/SUPPLIER : ADC ALLENCON DEVELOPMENT CORP.
SAMPLED/CAST BY : PINKY JOY V. FELLORES /LINNOR P. LOBATON
(Name of Authorized Representative) (Signature)

ME / ME DPWH Iloilo 2nd DEO/ADC 5/11/2023


(Designation) (Office) (Date)

Proposed Use : 310(1)c Bituminous Concrete Surface Wearing Course


Test Desired : 2- IRS
Governing Specification : :-
Shipped By : PJ V. FELLORES / L. LOBATON DPWH Iloilo 2nd DEO/ADC 5/12/2023
(Name & Designation) (Office) (Date)

Send Test Results to : DPWH Iloilo 2nd DEO, Balabag, Dumangas, Iloilo
(Mailing Address)
REMARKS :
:
Bill Charged To : ADC ALLENCON DEVELOPMENT CORP.
Submitted by : PINKY JOY V. FELLORES
Name & Designation (Signature)

: DPWH Iloilo 2nd DEO 5/12/2023


(Office) (Mailing Address) Date

Received by :
Name & Designation Date Time

Amount : Due Date: LAB. NO.:

Official Receipt No.

NOTED: MARK JOSEPH A. TOLENTINO


Laboratory Head

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