44 BULLETIN 555, U. S. DEPARTMENT OP AGRICULTURE. 



(Name and location of laboratory:) 



Report on Sample of Vitrified Paving Brick. 



(Date reported.) 



Laboratory No 



Trade name 



Identification marks 



Submitted by Title Address. 



Sampled , 191__ Received 



Sampled from 



Quantity represented 



Manufactured by 



Location used or to be used 



Examined for 



., 191__ 



., 191_. 



TEST RESULTS. 



General data. 



Average dimensions, length Width. 



Drying treatment 



Depth. 



Standardization data. 



Weight 

 of charge 



(after 

 standard- 

 ization. 



Number of fresh stave liners. 



Repairs affecting barrel. 



10 large spheres 

 ill 



small spheres. 

 Total 



Number of charges tested since last inspection, 



Running data. 



Time readings. 



Revolu- 

 tion 

 counter 

 readings. 



Running 



notes, 



stops, 



etc. 



Beginning of test. 

 Final reading 



Hours. 



Minutes. 



Seconds. 



Initial weight of 10 bricks. . . 



Final weight of 10 bricks 



Loss of weight 



Loss of weight , per cent 



Number of bricks broken in 

 test. 



Remarks : 



Maximum variation in per cent loss. 



Respectfully submitted, 



""(Title)! 



