Date Tested : Test Method : ASTM C-805, BS-181-202

Test Record No: Type Material Concrete : K

Location of Structure / Fdn Concrete : Project :

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ChimneyPadChimneyPadChimneyPadChimneyPad

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Tested By :

PT. BBSI

Checked By :

PT.BBSIApproved By :

PT. PLN Persero

Name :Name :Name :

Position :Position :Position :