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Sample Record for 2025-10-10-39

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 1000580 DEA: 071XW104 EFIS: 0723000028 QA Service Level: 1
DIST-CO-RTE-PM: 07---
Work Description: VENTURA COUNTY IN CITY OF FILLMORE VEN-126REPLACE/CONSTRUCT THE FILLMORE MAINTENANCESTATION DAMAGED BY HIGH WINDS DIR\\'S EMERGENCY
Location Description:
Contractor Name: MGP CONSTRUCTION DBA MICHAEL
Contractor Address: PO BOX 355, UPLAND, CA 91785
Resident Engineer: ALFRED IRA Structure Rep.: Heidi Bernstein

Sample Information

DIME Sample ID: 2025-10-10-39
TL Number from the TL Form: 10102025
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Acceptance
Type of Material: Concrete
Sample Taken Date: 10/10/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/13/2025
The quantity of what the sample constitutes: 130 CY
A brief description of the sample: 4X8 PCC cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 25-1136
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: State Ready Mix - Oxnard

Material Information

The concrete mix design number: 15056
The truck number from where the sample was collected: 1 to 7
The batch plant ticket number from where the sample was collected: 90166
Concrete batch plant: State Ready Mix
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: truck chute
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2025-10-10-39-1
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 10/24/2025
Date Tested: 10/24/2025
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 407-6963
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Unit system used? US Units
Number of specimens 3
Test performed With no density determined
Capped in accordance with? ASTM C617 - Sulfur Mortar Cap
Average diameter of cylinder 1 4.00 in
Average diameter of cylinder 2 4.01 in
Average diameter of cylinder 3 4.01 in
Cross sectional area of cylinder 1 12.57 in^2
Cross sectional area of cylinder 2 12.63 in^2
Cross sectional area of cylinder 3 12.63 in^2
Compressive strength (to nearest 10 psi) 4230 psi
Maximum load on cylinder 1 56095 lb
Maximum load on cylinder 2 47275 lb
Maximum load on cylinder 3 56556 lb
Compressive strength of cylinder 1 4462.6 psi
Type of fracture pattern of cylinder 1 2
Compressive strength of cylinder 2 3743.1 psi
Compressive strength of cylinder 3 4477.9 psi
Type of fracture pattern of cylinder 2 2
Type of fracture pattern of cylinder 3 2
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Correction factor for cylinder 2 1
Correction factor for cylinder 3 1
Age of specimen 14 days
Age of specimen in hours no data0 hours

Test 2 of 2

DIME Test ID: 2025-10-10-39-2
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 11/07/2025
Date Tested: 11/07/2025
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 407-6963
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Unit system used? US Units
Number of specimens 3
Test performed With no density determined
Capped in accordance with? ASTM C617 - Sulfur Mortar Cap
Average diameter of cylinder 1 4.01 in
Average diameter of cylinder 2 4.01 in
Average diameter of cylinder 3 4.01 in
Cross sectional area of cylinder 1 12.63 in^2
Cross sectional area of cylinder 2 12.63 in^2
Cross sectional area of cylinder 3 12.63 in^2
Compressive strength (to nearest 10 psi) 4920 psi
Maximum load on cylinder 1 68019 lb
Maximum load on cylinder 2 55323 lb
Maximum load on cylinder 3 63112 lb
Compressive strength of cylinder 1 5385.5 psi
Type of fracture pattern of cylinder 1 2
Compressive strength of cylinder 2 4380.3 psi
Compressive strength of cylinder 3 4997 psi
Type of fracture pattern of cylinder 2 2
Type of fracture pattern of cylinder 3 2
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Correction factor for cylinder 2 1
Correction factor for cylinder 3 1
Age of specimen 28 days
Age of specimen in hours no data0 hours