Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000793 DEA: 120K8704 EFIS: 1200020230
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-605-R0.6/R1.6
Work Description: MODIFY RAMPS, LIGHTING AND RAMP METERING SYSTEMS.
Location Description: ORANGE COUNTY IN LOS ALAMITOS FROM 0.8 MILE SOUTH TO 0.2 MILE NORTH OF KATELLA AVENUE UNDERCROSSING
Contractor Name: ORTIZ ENTERPRISES, INC.
Contractor Address: 6 CUSHING STE 200, IRVINE, CA 92618
Resident Engineer: Mario Leon Structure Rep.: Maheshwarlal Kapoor
DIME Sample ID: 2025-12-16-59
TL Number from the TL Form:
Sample Submitted By Organization: Surecast West
Sample Organization Contact: (951) 491-9506
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 12/16/2025
Date that the sample was received by the laboratory/organization performing the testing: 12/17/2025
The quantity of what the sample constitutes: 8.75 CY
A brief description of the sample: TYPE II /V
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CEMEX -REDLANDS
The concrete mix design number: 1610974
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 31840034
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: CONCRETE SAMPLE FROM WHEELBARRROW
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2025-12-16-59-1
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 01/13/2026
Date Tested: 01/07/2026
Submitted By Organization: Surecast West
Organization Address: 8203 Alabama Street,
Organization City: Redlands
Organization State: CA
Organization Zipcode: 92373
Organization Email: cody@surecastwest.com
Organization Phone: (951) 491-9506
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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3
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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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4.00 in
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Average diameter of cylinder 2
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4.00 in
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Average diameter of cylinder 3
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4.00 in
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Cross sectional area of cylinder 1
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12.57 in^2
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Cross sectional area of cylinder 2
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12.57 in^2
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Cross sectional area of cylinder 3
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12.57 in^2
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Compressive strength (to nearest 10 psi)
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6160 psi
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Maximum load on cylinder 1
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76100 lb
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Maximum load on cylinder 2
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77920 lb
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Maximum load on cylinder 3
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78350 lb
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Type of fracture pattern of cylinder 1
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1
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Type of fracture pattern of cylinder 2
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1
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Type of fracture pattern of cylinder 3
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1
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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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Correction factor for cylinder 3
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1
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Age of specimen
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9 days
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Age of specimen in hours
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no data0 hours
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