Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994405 DEA: 080F5414 EFIS: 0800000137 COOP: 081743
QA Service Level: 2
DIST-CO-RTE-PM: 08-RIV--
Work Description: RIV 71/91 FLYOVER
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Xavier Avila Structure Rep.: Nabil Shmara
DIME Sample ID: 2023-10-02-122
TL Number from the TL Form:
Sample Submitted By Organization: ZT Consulting Group, Incorporated
Sample Organization Contact: (818) 929-8162
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 10/02/2023
Date that the sample was received by the laboratory/organization performing the testing: 11/14/2023
The quantity of what the sample constitutes: 8890 sqft
A brief description of the sample: Concrete Cylinders
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Surecast West
The concrete mix design number: 1610974
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 30952401
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Surecast
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2023-10-02-122-1
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Submitted By Organization: ZT Consulting Group, Incorporated
Organization Address: 1041 East Green Street, Suite 204,
Organization City: Pasadena
Organization State: CA
Organization Zipcode: 91106
Organization Email: farzad@ztcgrp.com
Organization Phone: (818) 929-8162
Data has not been verified.
