BUILDING MATERIALS LABORATORY

PLANNING & MUNICIPALITY DEPARTMENT – AJMAN

Ajman, UAE , Tel. 06-7480573 Fax 06-7480673

CD-3-1-F06 REQUEST FOR IN - SITU DENSITY TESTS

Issue 2 Feb ‘14 BS 1377 : PART 9 : 1990(Amd. 8264/95) : CL. 2.2/ ASTM D 1556-2007
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CLIENT YOUSEF RASHED ALI AL SHAMSI INVOICE NO.
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CONTRACTOR AL FAEZAN CO., COMPANY REQUEST NO.
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CONSULTANT AL TAMEER ENG., CONSULTANT REPORT NO.
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OWNER YOUSEF RASHED ALI AL SHAMSI TEST LOCATED BY AML REPRESENTATIVE
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PROJECT NAME SHOPS GROUND FLOOR ONLY DATE REQUESTED
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PROJECT LOCATION AL HAMIDYA 1 -MIDDLE SECTOR -PLOT NO 2463 DATE OF TEST
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MATERIAL DESC. ROAD BASE WEATHER CONDITION
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SOURCE OF MATERIAL LOTAA CRUSHER COMPACTION REQD. 95% REFERENCE
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TYPE OF TESTS REGULAR / RETEST NO. OF TEST 3 O.M.C.(%) / M.D.D. (Mg/m3) /
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TEST METHOD ASTM D 1556-2007
BS 1377 : PART 9: 1990 ( AMD. 8264/95, Cl.2.2)
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Test Ref. Client’s No. / Request Road No./Location Abscissas/Coordinates Layer Level /BFRL Offset
M.H. No. No. Thickness(mm) (mm)
NP AL HAMIDYA 1 -MIDDLE SECTOR -PLOT NO 2463 NP 1 200 NP NP

Note: Please provide and type all information and cross at any items not applicable or input NP (Not Provided). Exp. Reporting Date:
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Contractor Name: ENG:MOHAMED Signature: Contact Tel: 0553062920 Remarks:
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Consultant Name: ENG:SAMEER Signature: Contact Tel: 0508968679 Consultant’s Stamp:
ÀRequired information.
Please fill all required information then print form for required signatures and stamps.