Examination Submission — Prescott Petrographics

Petrographic Examination Submission form

This completed form is required for any services to begin

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Type of samples submitted

Number Samples

Concrete mix information

Admixtures

Address of structure sampled from

Date concrete was placed

YYYY

When was distress first observed?

YYYY

Extent of Distress

Concrete Mix information

Testing Data from the project

Specific project instructions

Upload images of concrete or damage areas

FileField;Multiple;MaxSize = 9000kb; capture;

How Did You Hear About us?

Saw-cut specimens or chunks taken from the concrete can also be used.
If samples have not yet been taken from the structure, please contact Prescott Petrographics before specimen collection, for guidance on best location, size & number of specimens, this will ensure best results.
SHIPPING ADDRESS: Prescott Petrographics, 13150 N. Trail Blazer Dr., Prescott, AZ 86305.