Form 253 - Daily Report Portland Cement Concrete Ncdot Page 2

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Report No. ____________
M & T Form 253L
Date: __________
North Carolina Department of Transportation
DAILY REPORT ON PORTLAND CEMENT CONCRETE PAVEMENT
Field Lab Inspector’s Report
RECORD OF BEAMS TESTED
Specimen No.
Date Made
Date Tested
Age
Station No.
Depth
Width
Load (lbs.)
PSI
RECORD OF TEMPERATURES
TIME
Water
Water Bath
Water Bath
Water Bath
Water Bath
Water Bath
AIR TEMPERATURE
Bath 1
2
3
4
5
6
OUTSIDE
INSIDE
MAXIMUM
MINIMUM
Note: Curing temperatures should be obtained from automatically controlled recording thermometers whenever possible.
Technician Signature
PCCP Certification Number
By providing this data under my signature and/or HiCAMS certification number, I attest to the accuracy and
validity of the data contained on this form and certify that no deliberate misrepresentation of this data in any
manner has occurred.

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