REQUEST FORM FOR AGGREGATE TESTING

PROJECT DETAILS

ISTL CUSTOMER

CLIENT Musanada (Abu dhabi general service Company - musanada)

CONSULTANT Core Engineering Consultancy

CONTRACTOR AL Ryum Contracting & General Transport Co. LLC

PROJECT NAME Soft Landscaping Works For muhammad Bin Zayed City Zone C,D & G

PROJECT NO. IF-1-09-56220-01-C SENDER REF ARC/BG/04

PROJECT LOCATION MBZ

SAMPLE DETAILS FOR LABORATORY USE ONLY

20-40mm BLACK/GRAY gravel (Mir-

SAMPLE DESCRIPTION LAB REFERENCE NO.
00781,0782,0784,0785)

SOURCE OF SAMPLE M/S AL AMARA CRUSHER LLC LAB PROJECT NO.

SAMPLING CERTI. NO. SAMPLE BROUGHT BY CONSULTANT/CONTRACTOR

SAMPLED BY CONSULTANT/CONTRACTOR DATE SAMPLE RECEIVED 6/5/2023

SAMPLING DATE/TIME 5/30/2023 SAMPLE RECEIVED BY

CLIENT REF. NO. EXPECTED REPORTING DATE

SAMPLING METHOD CONDITION OF SAMPLE AS RECEIVED

SAMPLING LOCATION STORE YARD REQUIRED TEST METHOD PROVIDED BY
SAMPLE SIZE (Kg) 30 KG CUSTOMER/ CLIENT/ CONTRACTOR

LOT NO./LOT SIZE ENOUGH SAMPLE FOR ALL REQUESTED TEST

Remarks : ALL THE MANDATORY INFO. PROVIDED BY

CUSTOMER /CLIENT/ CONTRACTOR

ACCEPT REJECT

REQUIRED TEST DETAILS

No. of Test Method Status Specification
Sr no. Required Test Test Method
Specimen (Active/Superseded/Withdrawn)
1 WATER ABSORPTION ASTMC127 0.60%

2 PARTICLE SIZE DISTRIBUTION BS 812 20-40MM

3 PASSING 200 SIEVE ASTM 0.10%

Authorized Personnel Signatory Date Mobile Number

Contractor Representative

Client/ Consultant Representative

TF-059
Rev-04/Dec 21