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SCHMIDT HAMMER SURVEY – DATA SHEET

Project Project No.


Location Date

General Location Surveyed by

Grid Ref. Comp.


Structure Schmidt Hammer Reading Average
Number Strength

SKETCH

Remarks:

Tested by: Checked by:

CTTA #: CTTA #:

Dated:

Form # MAT 2.19 Issue # 2 Rev.1 01 April 2012

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