Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215365 DEA: 120Q9704 EFIS: 1218000010
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-405-0/11.4
Work Description: I-405 improvement project from I-5 to Harbor Boulevard including extend pavement life, improve safety, enhance traffic operation, and incorporate Intelligent Transportation Systems (ITS).
Location Description: Orange County I-405 PM 0 - 11.4
Contractor Name: Guy F. Atkinson
Contractor Address: 38 Executive Park, IRVINE CA 92614
Resident Engineer: Mona Shahidi Structure Rep.: Brian Vo
DIME Sample ID: 2025-04-11-75
TL Number from the TL Form:
Sample Submitted By Organization: Sequoia Consultants
Sample Organization Contact: (714) 974-6316
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 04/11/2025
Date that the sample was received by the laboratory/organization performing the testing: 04/12/2025
The quantity of what the sample constitutes: 1 per batch
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Associated RM
The concrete mix design number: 3F36L005
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 108203154
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: DS 216g GD1 Inlet @ STA 357+36.22
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2025-04-11-75-1
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 09/25/2025
Date Tested: 05/09/2025
Submitted By Organization: Sequoia Consultants
Organization Address: 361 West Grove Avenue,
Organization City: Orange
Organization State: CA
Organization Zipcode: 92865
Organization Email: sranjan@sequoiacon.com
Organization Phone: 1 (714) 974-6316
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Unit system used?
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US Units
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Number of specimens
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2
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Test performed
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With no density determined
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Capped in accordance with?
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ASTM C617 - Sulfur Mortar Cap
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Average diameter of cylinder 1
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6.00 in
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Average diameter of cylinder 2
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6.00 in
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Cross sectional area of cylinder 1
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28.27 in^2
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Cross sectional area of cylinder 2
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28.27 in^2
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Compressive strength (to nearest 10 psi)
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4170 psi
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Maximum load on cylinder 1
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119210 lb
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Maximum load on cylinder 2
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116800 lb
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Type of fracture pattern of cylinder 1
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4
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Type of fracture pattern of cylinder 2
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4
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Comment on any defect in either specimen or caps (Max 250 Characters)
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no data
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Correction factor for cylinder 1
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1
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Correction factor for cylinder 2
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1
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Age of specimen
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28 days
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Age of specimen in hours
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no data0 hours
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