Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994084 DEA: 060U8804 EFIS: 0616000074
QA Service Level: 1
DIST-CO-RTE-PM: 06-TUL-99-26.3/27.6
Work Description: CONSTRUCT A NEW INTERCHANGE AT COMMERCIAL AVENUE NOW CALLED INTERNATIONAL AGRI-CENTER WAY
Location Description: ON STATE ROUTE 99
Contractor Name: SECURITY PAVING COMPANY INC
Contractor Address: 13170 TELEFAIR AVE, SYLMAR, CA 91342
Resident Engineer: Alberto Lopez Structure Rep.: Vicente Sanchez
DIME Sample ID: 2025-11-12-46
TL Number from the TL Form: Unknown
Sample Submitted By Organization: G3 Quality, Incorporated - Cerritos
Sample Organization Contact: (562) 321-9840
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 11/12/2025
Date that the sample was received by the laboratory/organization performing the testing: 11/13/2025
The quantity of what the sample constitutes: 5
A brief description of the sample: 4x8 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification: Mix 180412
Structure unique identifier: 00-0000
Structure name: N/W Barrier Wall End Piece
The fabricator/manufacturer/facility name: CalPortland
The concrete mix design number: 180412
The truck number from where the sample was collected: Load
The batch plant ticket number from where the sample was collected: 0
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Set 1
A detailed description of where the material sample was collected: N/W Barrier Wall End Piece
Where the material sample would have been placed if not sampled: Unknown
From Lot No.: 1
Bag Lot No.: 1
DIME Test ID: 2025-11-12-46-1
Test Method: CTM 518-June 2010: Method of Test for Unit Weight of Fresh Concrete
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
Data has not been verified.
DIME Test ID: 2025-11-12-46-2
Test Method: CTM 504-June 2010: Method of Test for Determining Air Content of Freshly Mixed Concrete by the Pressure Method
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
Data has not been verified.
DIME Test ID: 2025-11-12-46-3
Test Method: CTM 556-January 2018: Method of Test for Slump of Fresh Portland Cement Concrete
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
Data has not been verified.
DIME Test ID: 2025-11-12-46-4
Test Method: CTM 557-June 2020: Method of Test for Temperature of Freshly Mixed Hydraulic Cement Concrete
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
Data has not been verified.
DIME Test ID: 2025-11-12-46-5
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
Data has not been verified.
