Sample Record for 2017-08-09-9
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 211778 DEA: 04235654 EFIS: 0400000680
QA Service Level: 1
DIST-CO-RTE-PM: 04-SM-101,114-1.3/2.5,5.0/5.3
Work Description: RECONSTRUCT INTERCHANGE
Location Description: SAN MATEO COUNTY AT VARIOUS LOCATIONS ON ROUTE 101 FROM 0.4 MILE NORTH OF UNIVERSITY AVENUE OVERCROSSING TO 0.6 MILE SOUTH OF HENDERSON UNDERPASS AND ON ROUTE 114 FROM WILLOW ROAD SEPARATION TO NEWBRIDGE STREET
Contractor Name: Disney/OC Jones Construction Company Inc.
Contractor Address: 533 Airport Blvd, Suite 120, Burlingame, CA 94010
Resident Engineer: Fernando Abela Structure Rep.: Oanh Bui
Sample Information
DIME Sample ID: 2017-08-09-9
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Informational
Type of Material: Concrete
Sample Taken Date: 08/09/2017
Date that the sample was received by the laboratory/organization performing the testing: 08/29/2017
The quantity of what the sample constitutes: 2
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: kiecon
Material Information
The concrete mix design number: ct60vt2
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: unk
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: fabricator
Where the material sample would have been placed if not sampled: Unknown
From Lot No.: Unknown
Bag Lot No.: Unknown
Test Results
Test 1 of 1
DIME Test ID: 2017-08-09-9-2
Test Method: ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Capped in accordance with ASTM C1231 Cured in accordance with ASTM C511
Submitted By Organization: CT HQ - Vallejo Field Laboratory
Organization Address: 690 Walnut Avenue, Suite 150,
Organization City: Vallejo
Organization State: CA
Organization Zipcode: 94592
Organization Email: nikhil.moon@dot.ca.gov
Organization Phone: (682) 256-3796
Data has not been verified.
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| 2017-08-09-9-1 | ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens | 03/07/2018 | 09/06/2017 | William Sommer | CT HQ - QASI Bay Area Field Office | | |
14265
