Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 210837 DEA: 080J0804 EFIS: 0800000283 COOP: 081625
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-15-34.7/51.6
Work Description: (Alternative Delivery) DESIGN-BUILD OF THE INTERSTATE 15 EXPRESS LANES PROJECT
Location Description: Riverside County and SBD-15-0.0/1.3
Contractor Name: Skanska-Ames, Joint Venture
Contractor Address: 1801 California Avenue, Corona, CA 92881
Resident Engineer: Roy Fisher (reports) Structure Rep.: Roy Fisher
DIME Sample ID: 2019-09-26-9
TL Number from the TL Form: 107
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: 09/26/2019
Date that the sample was received by the laboratory/organization performing the testing: 09/30/2019
The quantity of what the sample constitutes: 4
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 974-107
Structure unique identifier:
Structure name: ECOH PIER PROTECTION WALLS RIGHT
The fabricator/manufacturer/facility name: ROBERTSON CORONA
The concrete mix design number: SC675B38
The truck number from where the sample was collected: 1758
The batch plant ticket number from where the sample was collected: 4953070
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: SKANSKA AMES
A detailed description of where the material sample was collected: 60 CY
Where the material sample would have been placed if not sampled: ECOH PIER PROTECTION WALLS RIGHT
From Lot No.: Unknown
Bag Lot No.: Unknown
DIME Test ID: 2019-09-26-9-1
Test Method: ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Capped in accordance with ASTM C617/CTM521 Cured in accordance with ASTM C511
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: (909) 829-3029
Data has not been verified.
