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Sample Record for 2022-01-21-3

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

Project Information

Project ID: 214524 DEA: 07304504 EFIS: 0714000067 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-57-R0.0/R4.5
Work Description: CONCRETE PAVEMENT, CONCRETE BARRIER, AND ELECTRICAL WORK.
Location Description: LOS ANGELES COUNTY IN DIAMOND BAR AND CITY OF INDUSTRY FROM ORANGE COUNTY LINE TO ROUTE 57/60 SEPARATION
Contractor Name: Griffith Company
Contractor Address: 3050 E. Birch Street, Brea, CA 92821
Resident Engineer: Martin Sandoval Structure Rep.: Avtar Bains

Sample Information

DIME Sample ID: 2022-01-21-3
TL Number from the TL Form:
Sample Submitted By Organization: Kleinfelder, Incorporated - Los Angeles
Sample Organization Contact: (909) 833-5780
Type of Sample: Per Request
Type of Material: Concrete
Sample Taken Date: 01/21/2022
Date that the sample was received by the laboratory/organization performing the testing: 01/22/2022
The quantity of what the sample constitutes: Per 1000 CY
A brief description of the sample: A set of 2 PCC concrete beam test specimens
From where was the sample collected: Job Site
Laboratory sample identification: 220075
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vanguard at the 57 Freeway

Material Information

The concrete mix design number: 57030SL
The truck number from where the sample was collected: Load 14
The batch plant ticket number from where the sample was collected: 9026
Concrete batch plant: Vanguard at 57 Freeway
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: In-place
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2022-01-21-3-1
Test Method: ASTM C138-17a: Standard Test Method for Density (Unit Weight), Yield, and Air Content (Gravimetric) of Concrete
Verified Date: 01/23/2022
Date Tested: 01/21/2022
Submitted By Organization: Kleinfelder, Incorporated - Los Angeles
Organization Address: 620 South Magnolia Avenue, Building G,
Organization City: Ontario
Organization State: CA
Organization Zipcode: 91762
Organization Email: mdorsch@kleinfelder.com
Organization Phone: (909) 833-5780
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Identification of concrete represented by the sample 220075
Volume of the measure 0.249 ft^3
Density of concrete 146.2 lb/ft^3
Yield of concrete 9.5 yd^3
Relative yield of the batch no data
Cement content 415 lb/yd^3
Air content 3.6 %

Test 2 of 2

DIME Test ID: 2022-01-21-3-2
Test Method: CTM 533-June 2010: Method of Test for Ball Penetration in Fresh Portland Cement Concrete
Verified Date: 01/23/2022
Date Tested: 01/21/2022
Submitted By Organization: Kleinfelder, Incorporated - Los Angeles
Organization Address: 620 South Magnolia Avenue, Building G,
Organization City: Ontario
Organization State: CA
Organization Zipcode: 91762
Organization Email: mdorsch@kleinfelder.com
Organization Phone: (909) 833-5780
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Ball penetration in freshly mixed concrete (average) 1 inch