Project Name*

Engineer of Record*

Test Date*

Client / Owner

Structure Name*

Test ID*

Load Test Type*

Reference Standard

Load Type Applied*

Total Applied Test Load (kips)*

Design / Rating Load (kips)

Load Factor Applied

Test load / design load ratio

Loading Sequence Description

Load Placement Description

Ambient Temperature (°F)

Weather Conditions

Initial Reading - Baseline (mm)

Zero load / pre-test baseline deflection

Maximum Measured Deflection (mm)

Deflection at full test load

Residual Deflection After Unloading (mm)

Permanent set after full load removal

Allowable / Predicted Deflection (mm)

Calculated or code limit

Deflection Ratio (measured / allowable)

Values > 1.0 indicate exceedance

Recovery Ratio (%)

Elastic recovery after unloading. ACI 318 requires >= 75%

Deflection Measurement Notes

Strain Gauges UsedStrain Gauges Used

Acoustic Emission (AE) Monitoring UsedAcoustic Emission (AE) Monitoring Used

Automated Data Logger UsedAutomated Data Logger Used

Crack Growth or New Cracking Observed During TestCrack Growth or New Cracking Observed During Test

Sensor Data Notes

Deflection Criterion*

Recovery Criterion*

No Distress Criterion*

Overall Test Result*

Test Summary

Engineer of Record Comments

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