Sample Record for 2025-08-10-14
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000889 DEA: 081M7404 EFIS: 0822000036
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-210-1.2/1.6
Work Description: JPCP (RSC), RDWY EXC, LCB RAPID SETTING, & HMA (TYPE A).
Location Description: SANBERNARDINO COUNTY IN UPLAND FROM 0.3 MILE WEST TO 0.1 MILE EAST OF MOUNTAIN AVENUE OVERCROSSING
Contractor Name: INTERSTATE CIVIL CONSTRUCTION
Contractor Address: PO Box 2819, Wrightwood, CA 92397
Resident Engineer: Vu T. Nguyen Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2025-08-10-14
TL Number from the TL Form: G081025-6
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 08/10/2025
Date that the sample was received by the laboratory/organization performing the testing: 07/11/2025
The quantity of what the sample constitutes: 3
A brief description of the sample: CONCRETE CYLINDERS
From where was the sample collected: Job Site
Laboratory sample identification: G081025-6
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: NA
Material Information
The concrete mix design number: 1621261 FLEX
The truck number from where the sample was collected: 76237
The batch plant ticket number from where the sample was collected: 31705047
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: RTE 210 FROM 0.3 MI W. TO 0.1 MI E. OF Mtn. Ave. OC
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test Results
Test 1 of 1
DIME Test ID: 2025-08-10-14-1
Test Method: ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Capped in accordance with ASTM C617 - Sulfur Mortar Cap Cured in accordance with ASTM C511
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: (909) 829-3029
Data has not been verified.
