Sample Record for 2025-11-03-29
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000681 DEA: 081J7204 EFIS: 0818000099
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-40-S0.0/S0.8,0.0/R15.0
Work Description: REPLACE AC SURFACING, COLD PLANE AC PAVEMENT, HMA, RSP, AND MGS.
Location Description: SAN BERNARDINO COUNTY IN AND NEAR BARSTOW FROM 0.1 MILE WEST OF ROBERTA STREET TO MONTARA ROAD AND FROM ROUTE 15 TO 0.4 MILE EAST OF LAVA WASH BRIDGE
Contractor Name: SULLY-MILLER CONTRACTING COMPANY
Contractor Address: Unknown
Resident Engineer: Khoa Nguyen Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2025-11-03-29
TL Number from the TL Form:
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: 11/03/2025
Date that the sample was received by the laboratory/organization performing the testing: 11/05/2025
The quantity of what the sample constitutes: 2
A brief description of the sample: 6x12
From where was the sample collected: Job Site
Laboratory sample identification: 1082-3
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: sully
Material Information
The concrete mix design number: SC590B33
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 567472
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: sr i-40 e/b & hidden springs
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test Results
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| 2025-11-03-29-1 | ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens | 11/05/2025 | 12/01/2025 | Jose Guzman | CT D08 - Fontana Southern Regional Laboratory | | Matthew Clayton |
149363
