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Project : Reference Test I.D. No. 22NOOO103 -Construction of Bislig Bridge (Surigao -Davao Coastal Road)
: Surigao del Sur
(Name) (City Province)
Kind of Material : Coarse Aggregate (Crushed)
Sample Identification : CA-01
Quantity Represented : 1,500 cu.m
Sampled at : Crusher Plant Stockpile
Original Source : Simulao River Quarry, Sta. Maria, Trento, Agusan del Sur
Supplied by : J.M. LUCIANO Construction Incorporation
Proposed Use : For Reference
Spec's Item No. : (AASHTO T27/AASHTO T19/AASHTO T84/AASHTO T85/AASHTO T96)
Sampled by : LILIBETH T. TIROL/GINA T. PAZ -Contractor Representative 6-Jul-2022
: (Name & Designation) (Date)
Submitted by : J.M. LUCIANO Construction Incorporation - Representative 6-Jul-2022
: (Name & Designation) (Office) (Date)
Contractor : J.M. LUCIANO Construction Incorporation - Representative
ATTESTED BY:
R.13/12.6/qas/edc.
Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
AGUSAN DEL SUR 2ND
DISTRICT ENGINEERING OFFICE
REGIONAL OFFICE XIII
San Francisco, Agusan del Sur
Project : Reference Test I.D. No. 22NOOO103 -Construction of Bislig Bridge (Surigao -Davao Coastal Road)
Surigao del Sur
(Name) (City Province)
Kind of Material : Fine Aggregate
Sample Identification : FA -01
Quantity Represented : 1,500 cu.m
Sampled at : Jobsite
Original Source : Sta. Josefa River Quarry, Sta. Josefa, Agusan del Sur
Supplied by : J.M. LUCIANO Construction Incorporation
Proposed Use : For Reference
Spec's Item No. : (AASHTO T 27/AASHTO T85/AASHTO T 84/AASHTO T 19)
Sampled by : LILIBETH T. TIROL/GINA T. PAZ -Contractor Representative 6-Jul-2022
: (Name & Designation) (Date)
Submitted by : J.M. LUCIANO Construction Incorporation - Representative DPWH ADS 2ND DEO 6-Jul-2022
: (Name & Designation) (Office) (Date)
Contractor : J.M. LUCIANO Construction Incorporation - Representative
R.13/12.6/qas/edc.
R.13/12.6/qas/edc.
R.13/12.6/qas/edc.
Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
AGUSAN DEL SUR 2ND
DISTRICT ENGINEERING OFFICE
REGIONAL OFFICE XIII
San Francisco, Agusan del Sur
Project : Reference Test I.D. No. 22NOOO103 -Construction of Bislig Bridge (Surigao -Davao Coastal Road)
: Surigao del Sur
(Name) (Number) (City/Province)
Contractor : J.M. LUCIANO Construction Incorporation
(Give as accurate location as possible)
Original Source : Simulao River Quarry, Sta. Maria, Trento & Sta. Josefa Quarry, Agusan del Sur
(Pit, Quarry, River, etc. and location)
Proposed Use : For Reference Spec's Item No.
FINE AGGREGATE
COARSE AGGREGATE
1. Container + Wet Soil, g 4,450.00
2. Container + Oven - Dried soil, g 4,409.00
3. Water, g (1) - (2) 41.00
4. Container, g 255.00
5. Dry soil, g (2) - (4) 4,154.00
6. Moisture Content, % (3) x 100
0.99
(5)
NOTED:
LEODEGARIO M. MAZO
Engineer III
Chief, Quality Assurance Section
R.13/12.6/qas/edc.
Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
AGUSAN DEL SUR 2ND
DISTRICT ENGINEERING OFFICE
REGIONAL OFFICE XIII
San Francisco, Agusan del Sur
Project : Reference Test I.D. No. 22NOOO103 -Construction of Bislig Bridge (Surigao -Davao Coastal Road)
: Surigao del Sur
(Name) (Number) (City/Province)
Contractor : J.M. LUCIANO Construction Incorporation
Original Source : Simulao River Quarry, Sta. Maria, Trento, Agusan del Sur
(Pit, Quarry, River, etc. and location)
Sampled by : LILIBETH T. TIROL/GINA T. PAZ -Contractor Representative 6-Jul-2022
(Name and Designation) (Date)
Tested by : Edna D. Curato - Laboratory Technician II DPWH ADS 2ND DEO 11-Jul-2022
(Name and Designation) (Office) (Date)
Computed by : Edna D. Curato - Laboratory Technician II DPWH ADS 2ND DEO 15-Jul-2022
(Name and Designation) (Office) (Date)
NOTED:
LEODEGARIO M. MAZO
Engineer III
Chief, Quality Assurance Section
R.13/12.6/qas/edc.
Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
AGUSAN DEL SUR 2ND
DISTRICT ENGINEERING OFFICE
REGIONAL OFFICE XIII
San Francisco, Agusan del Sur
Project : Reference Test I.D. No. 22NOOO103 -Construction of Bislig Bridge (Surigao -Davao Coastal Road)
: Surigao del Sur
(Name) (Number) (City/Province)
Contractor : J.M. LUCIANO Construction Incorporation
Original Source : Simulao River Quarry, Sta. Maria, Trento & Sta. Josefa Quarry, Agusan del Sur
(Pit, Quarry, River, etc. and location)
Tested by : Edna D. Curato - Laboratory Technician II DPWH ADS 2ND DEO 7-Jul-2022
(Name and Designation) (Office) (Date)
Computed by : Edna D. Curato - Laboratory Technician II DPWH ADS 2ND DEO 7-Jul-2022
(Name and Designation) (Office) (Date)
Lab No. : 07072022-1208
NOTED:
LEODEGARIO M. MAZO
Engineer III
Chief, Quality Assurance Section
R.13/12.6/qas/edc.
Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
AGUSAN DEL SUR 2ND
DISTRICT ENGINEERING OFFICE
REGIONAL OFFICE XIII
San Francisco, Agusan del Sur
Project : Reference Test I.D. No. 22NOOO103 -Construction of Bislig Bridge (Surigao -Davao Coastal Road)
: Surigao del Sur
(Name) (Number) (City Province)
Contractor : J.M. LUCIANO Construction Incorporation
Kinds of Material : Coarse Aggregate Spec's/Item No. : 405
Sampled at : Jobsite
Original Source : Simulao River Quarry, Sta. Maria, Trento, Agusan del Sur
(Pit, quarry, river, etc and location)
Sampled by : LILIBETH T. TIROL/GINA T. PAZ -Contractor Representative 6-Jul-2022
(Name & Designation) (Date)
Tested by : Edna D. Curato - Laboratory Technician II DPWH ADS 2ND DEO 11-Jul-2022
(Name & Designation) (Office) (Date)
Computed by : Edna D. Curato - Laboratory Technician II DPWH ADS 2ND DEO 14-Jul-2022
(Name & Designation) (Office) (Date)
GINA T. PAZ
Engineer - II
R.13/12.6/qas/edc.
Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
AGUSAN DEL SUR 2ND
DISTRICT ENGINEERING OFFICE
REGIONAL OFFICE XIII
San Francisco, Agusan del Sur
Project : Reference Test I.D. No. 22NOOO103 -Construction of Bislig Bridge (Surigao -Davao Coastal Road)
: Surigao del Sur
(Name) (Number) (City Province)
Contractor : J.M. LUCIANO Construction Incorporation
Kinds of Material : Fine Aggregate Spec's/Item No. : 0
Sampled at : Jobsite
(Give accurate location as possible)
Original Source : Sta. Josefa River Quarry, Sta. Josefa, Agusan del Sur
(Pit, quarry, river, etc and location)
Sampled by : LILIBETH T. TIROL/GINA T. PAZ -Contractor Representative 6-Jul-2022
(Name & Designation) (Date)
Tested by : Edna D. Curato - Laboratory Technician II DPWH ADS 2ND DEO 11-Jul-2022
(Name & Designation) (Office) (Date)
Computed by : Edna D. Curato - Laboratory Technician II DPWH ADS 2ND DEO 15-Jul-2022
(Name & Designation) (Office) (Date)
GINA T. PAZ
Engineer - II
R.13/12.6/qas/edc.
R.13/12.6/qas/edc.
Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
AGUSAN DEL SUR 2ND
DISTRICT ENGINEERING OFFICE
REGIONAL OFFICE XIII
San Francisco, Agusan del Sur
Project : Reference Test I.D. No. 22NOOO103 -Construction of Bislig Bridge (Surigao -Davao Coastal Road)
: Surigao del Sur
(Name) (Number) (City Province)
Contractor : J.M. LUCIANO Construction Incorporation
Original Source : Simulao River Quarry, Sta. Maria, Trento & Sta. Josefa Quarry, Agusan del Sur
(Pit, Quarry, River, etc. and location)
Tested by : Edna D. Curato - Laboratory Technician II DPWH ADS 2ND DEO 7-Jul-2022
(Name and Designation) (Office) (Date)
Computed by : Edna D. Curato - Laboratory Technician II DPWH ADS 2ND DEO 14-Jul-2022
(Name and Designation) (Office) (Date)
Lab. No. : 07072022-1209
NOTED:
LEODEGARIO M. MAZO
Engineer III
Chief, Quality Assurance Section
R.13/12.6/qas/edc.