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Sample Record for 2019-09-03-12

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 211260 DEA: 072159U4 EFIS: 0715000160 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,ORA-5-0.0/1.5, 44.3/44.4
Work Description: CONSTRUCT HOV LANES AND MIX FLOW LANES.
Location Description: LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 TOWNSGATE RD. SUITE 200, WESTLAKE VILLAGE, CA 91361
Resident Engineer: George Saker Structure Rep.: Danny Lalonde

Sample Information

DIME Sample ID: 2019-09-03-12
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: 09/03/2019
Date that the sample was received by the laboratory/organization performing the testing: 09/04/2019
The quantity of what the sample constitutes: 6
A brief description of the sample: 6x12 Cylinders
From where was the sample collected: Job Site
Laboratory sample identification: Set 3
Structure unique identifier: 00-0000
Structure name: Unknown
The fabricator/manufacturer/facility name: Jobsite

Material Information

The concrete mix design number: S72500
The truck number from where the sample was collected: Load 27
The batch plant ticket number from where the sample was collected: 0
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Set 3
A detailed description of where the material sample was collected: Bridge 53-3058k Stem and Soffit
Where the material sample would have been placed if not sampled: Unknown
From Lot No.: Unknown
Bag Lot No.: Unknown
Test results on following page(s): 6

Test Results

Test 1 of 6

DIME Test ID: 2019-09-03-12-1
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 10/18/2019
Date Tested: 09/11/2019
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens 2
Average Compressive Strength (to nearest 10) 3100 lb/in^2
Cylinder Age 7 days
Break Description of Cylinder 1 (if not 'cone') no data
Break Description of Cylinder 2 (if not 'cone') no data

Test 2 of 6

DIME Test ID: 2019-09-03-12-2
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 10/18/2019
Date Tested: 10/02/2019
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens 2
Average Compressive Strength (to nearest 10) 4510 lb/in^2
Cylinder Age 28 days
Break Description of Cylinder 1 (if not 'cone') no data
Break Description of Cylinder 2 (if not 'cone') no data

Test 3 of 6

DIME Test ID: 2019-09-03-12-3
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 10/18/2019
Date Tested: 10/16/2019
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens 2
Average Compressive Strength (to nearest 10) 4840 lb/in^2
Cylinder Age 42 days
Break Description of Cylinder 1 (if not 'cone') no data
Break Description of Cylinder 2 (if not 'cone') no data

Test 4 of 6

DIME Test ID: 2019-09-03-12-4
Test Method: CTM 557-July 2012: Method of Test for Temperature of Freshly Mixed Portland Cement Concrete
Verified Date: 10/18/2019
Date Tested: 09/03/2019
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Temperature of the freshly mixed concrete 87 F

Test 5 of 6

DIME Test ID: 2019-09-03-12-5
Test Method: CTM 504-June 2010: Method of Test for Determining Air Content of Freshly Mixed Concrete by the Pressure Method
Verified Date: 10/18/2019
Date Tested: 09/03/2019
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Air Content 1 %

Test 6 of 6

DIME Test ID: 2019-09-03-12-6
Test Method: CTM 533-June 2010: Method of Test for Ball Penetration in Fresh Portland Cement Concrete
Verified Date: 10/18/2019
Date Tested: 09/03/2019
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Ball penetration in freshly mixed concrete (average) 5 inch