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The NYC TR2 form serves as a critical document in the construction process, particularly concerning concrete sampling and testing. This form is essential for ensuring that concrete used in construction projects meets the required standards and specifications. It requires detailed information about the project location, including the house number, street name, borough, and relevant block and lot numbers. Additionally, the form mandates the inclusion of information about the licensed concrete testing laboratory, such as the director’s name, contact details, and license numbers. Responsibilities of the laboratory must be clearly identified, with certifications affirming compliance with New York City Construction Codes. The form also necessitates signatures from various parties involved, including the design applicant and building owner, to confirm their acceptance of the testing laboratory and the accuracy of the reported results. Furthermore, it emphasizes the importance of adhering to regulations, highlighting the serious consequences of falsifying any information. Ultimately, the NYC TR2 form plays a vital role in maintaining safety and quality standards in construction, ensuring that all parties are accountable for the integrity of the materials used in building projects.

Preview - Nyc Tr2 Form

TR2: Technical Report

Concrete Sampling and Testing

Orient and affix BIS

job number label here

Must be typewritten.

Sheet number 1

1Location Information Required for ALL applications.

House No(s)

Street Name

 

 

 

 

 

 

 

 

Borough

Block

Lot

BIN

CB No.

 

 

 

 

 

Work on Floor(s)

 

 

 

Apt/Condo No(s)

 

 

 

 

 

2

Licensed Concrete Testing Lab Information Required for ALL applications.

 

 

 

 

 

 

 

 

 

Director Last Name

 

Director First Name

Director Middle Initial

 

 

 

 

 

 

 

 

 

Business Name

 

 

 

 

 

Business Telephone

 

 

 

 

 

 

 

 

 

Business Address

 

 

 

 

 

Business Fax

 

 

 

 

 

 

 

 

 

City

State

 

Zip

Mobile Telephone

 

 

 

 

 

 

 

 

 

E-Mail

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Director’s Lic. Number

 

 

P.E.

 

R.A.

Concrete Testing Lab Lic. Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

Licensed Concrete Testing Laboratory’s Identification of Responsibilities Required prior to Permit.

 

 

 

 

 

 

 

 

 

Check all that apply below:

 

 

 

 

 

 

I certify that I am the director of the licensed concrete testing laboratory accepting responsibility for conducting the testing in accordance with BC 1905.6 and BC 1704.1. I further certify that I have read the applicable sections of the New York City Construction Codes in connection with the testing of concrete and licensed concrete testing laboratories as well as 1 RCNY §5-02 and 1 RCNY §101-07(c)(6), which specifies the qualifications and duties required of a licensed concrete testing laboratory and that this licensed testing laboratory meets those qualifications for the work for which I take responsibility. I agree that both I and the licensed concrete testing laboratory will comply with all provisions of the New York City Construction Codes as well as 1 RCNY §5-02 and 1 RCNY §101-07(c)(6). I am aware of the additional sanctions imposed on false filings by §28-211.1.2 of the Administrative Code.

Change of Applicant: I am a newly designated individual responsible for the testing specified herein and I hereby state that: None of the tests indicated herein have been performed to date by the previously designated individual.

Some of the tests indicated herein have been performed by the previously designated individual, as indicated in the attached report.

I am aware of the additional sanctions imposed on false filings by §28-211.1.2 of the Administrative Code.

Name (please print)

Signature

Date

P.E. / R.A. Seal (apply seal, then sign and date over seal)

10/09

TR2

Sheet number 2

 

 

 

 

 

 

 

4

Design Applicant’s Statement and Signature P.E./R.A. Required prior to Permit.

 

 

 

 

I certify that the licensed concrete testing laboratory specified in section 2 above and engaged by the owner to perform tests on the work at the location specified in section 1 above is acceptable. (BC 1704.1)

Name (please print)

Signature

Date

 

 

P.E. / R.A. Seal (apply seal, then sign and date over seal)

5Building Owner’s Statement and Signature Required prior to Permit.

I certify that I have employed the licensed concrete testing laboratory specified in section 2 above in accordance with BC 1704.1. Falsification of any statement is a misdemeanor and is punishable by a fine or imprisonment, or both. It is unlawful to give to a city employee, or for a city employee to accept, any benefit, monetary or otherwise, either as a gratuity for properly performing the job or in exchange for special consideration. Violation is punishable by a fine or imprisonment, or both. I understand that if I am found after hearing to have knowingly or negligently made a false statement or to have knowingly or negligently falsified or allowed to be falsified any certificate, form, signed statement, application, report or certification of the correction of a violation required under the provisions of this code or of a rule of any agency, I may be barred from filing further applications or documents with the Department.

Name (print)

Title

 

 

Signature

Date

 

 

STOP HERE PRIOR TO PERMIT

10/09

TR2

Sheet number

of

sheets

 

 

 

 

 

 

 

6Test Report Required prior to Sign-off. Use supplemental pages as needed. Attach Original Lab Test Reports

Specified Concrete Str. (f’c):

 

PSI

 

 

Specified Test Age (days):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Field Testing Results:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Test Report

Date of

Cylinder I.D.

Slump

Air Content

Temperature

Weight

 

Placement

Total

Breaking

Number

Placement

 

 

 

 

 

 

Location

Placement

Strength

 

 

 

 

 

 

 

 

 

 

 

 

 

 

in

%

°F

 

lbs/ft3

 

yd3

PSI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Licensed Concrete Lab Director Name (please print)

Signature

Date

 

 

P.E. / R.A. Seal (apply seal, then sign and date over seal)

10/09

TR2

Sheet number of sheets

7 Licensed Concrete Testing Laboratory’s Certification of Completion Required prior to Sign-off.

I certify that I have completed the testing specified herein and that the results reported in section 6 of this form are true and accurate in accordance with §28-406.3.2.

I am aware of the additional sanctions imposed on false filings by §28-211.1.2 of the Administrative Code.

Withdrawal of Applicant: I am withdrawing responsibility for conducting the tests indicated herein and herewith submit the results or status of the work performed to date.

Name (please print)

Signature

Date

 

 

P.E. / R.A. Seal (apply seal, then sign and date over seal)

8 Design Applicant’s Statements and Signatures Required prior to Sign-off. P.E./R.A. responsible for plans, choose one and sign/seal.

I certify I have reviewed the test results reported by the licensed concrete testing lab in section 6 above and found them to be in compli- ance with the approved construction documents.

I certify I have reviewed the test results reported by the licensed concrete testing lab in section 6 above and found them to be in compli- ance with the approved construction documents except as noted in the attached report (BC 1905.6.3.3)

Note: design applicant’s signed and sealed report must be attached to this document

Name (please print)

Signature

Date

 

 

P.E. / R.A. Seal (apply seal, then sign and date over seal)

9Concrete Producer’s Statement and Signature Required prior to Sign-off. Must be filled out by Owner of Production Facility.

I certify that the test results reported in section 6 above were reported to me, and I further certify that the concrete delivered is in accordance with the design mix(es) specified on the TR3 submitted for the work specified in section 1 above.

 

Name (print)

 

Title

 

 

 

 

 

Signature

Date

NRMCA Expiration Date (BC 1905.8.2)

 

 

 

 

 

Business Name

 

Business Telephone

 

 

 

 

 

Business Address

 

Business Fax:

 

 

 

 

 

City

State

Zip

 

 

 

 

 

 

 

 

10/09

Form Characteristics

Fact Name Fact Description
Form Purpose The NYC TR2 form is used for documenting concrete sampling and testing, ensuring compliance with city construction codes.
Mandatory Information All applications must include location information, such as house number, street name, borough, block, and lot.
Licensed Lab Details Information about the licensed concrete testing laboratory, including the director's name and contact details, is required.
Responsibilities The director of the concrete testing lab must certify their responsibilities in accordance with specific sections of the New York City Construction Codes.
Falsification Penalties Falsifying any statements on the TR2 form can result in misdemeanor charges, fines, or imprisonment.
Signatures Required Multiple signatures are required on the form, including those from the design applicant, building owner, and concrete lab director.
Testing Certification The licensed concrete testing laboratory must certify the completion and accuracy of the testing results before sign-off.
Governing Laws The TR2 form is governed by New York City Construction Codes, particularly BC 1704.1 and relevant sections of the Administrative Code.
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