Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002668 DEA: 080R42A4 EFIS: 0812000076
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD--unknown
Work Description: BUILDING MAINTENANCE FACILITY IN THE CITY OF FONTANA ON SE QUADRANT OF SR 210 & I-15 IC
Location Description: 0R42A BUILD MAINTENANCE FACILITY ADJACENT TO SOUTHERN REGIONAL LAB (DESIGN BUILD)
Contractor Name: Exbon Development
Contractor Address: 13831 Newhope St., Garden Grove, CA
Resident Engineer: Alfonso Gonzales Structure Rep.: Oluwatayo Ogeyemi
DIME Sample ID: 2026-10-28-36
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: 10/28/2026
Date that the sample was received by the laboratory/organization performing the testing: 05/22/2026
The quantity of what the sample constitutes: 9
A brief description of the sample: 4x8 cylinders
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Exbon Development Inc.
The concrete mix design number: 3H40L024
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 10604874
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Maintenance Facility Adjacent to SRL
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2026-10-28-36-1
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Verified Date: 11/04/2026
Date Tested: 11/04/2026
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: (213) 792-4797
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 C1231 - Unbonded Elastomeric Pad Cap
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Apparent mass of submerged cylinder 1
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no data0 lb
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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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2770 psi
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Maximum load on cylinder 1
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32270 lb
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Maximum load on cylinder 2
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34320 lb
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Maximum load on cylinder 3
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37730 lb
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Compressive strength of cylinder 1
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2570.0 psi
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Type of fracture pattern of cylinder 1
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3
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Compressive strength of cylinder 2
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2730.0 psi
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Compressive strength of cylinder 3
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3000 psi
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Type of fracture pattern of cylinder 2
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2
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Type of fracture pattern of cylinder 3
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2
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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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7 days
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Age of specimen in hours
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no data0 hours
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Serial number of delivery ticket, if available
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no data
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