Sample Record for 2015-03-12-4
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 3825 DEA: 07138204 EFIS: 0700000142
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-47,103-3.5/4.6,0.0/1.1
Work Description: REPLACE STEEL BRIDGE WITH CIP PS CONCRETE BOX GIRDER BRIDGE AND RAMPS.
Location Description: LOS ANGELES COUNTY IN LONG BEACH AND LOS ANGELES ON ROUTE 47 FROM OCEAN BOULEVARD TO ROUTE 103 JUNCTION AND ON ROUTE 103 FROM ROUTE 47 JUNCTION TO ANAHEIM STREET OVERHEAD
Contractor Name: M C M CONSTRUCTION INC
Contractor Address: P O BOX 620, NORTH HIGHLANDS, CA 95660
Resident Engineer: Daniel Leon Structure Rep.: Andy Chen
Sample Information
DIME Sample ID: 2015-03-12-4
TL Number from the TL Form: 193964
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 03/12/2015
Date that the sample was received by the laboratory/organization performing the testing: 03/16/2015
The quantity of what the sample constitutes: 2
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification: Unknown
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: 47 AND 103
Material Information
The concrete mix design number: S85156
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: 136745
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: JOINT SEAL ASSEMBLY
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test Results
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| 2015-03-12-4-1 | CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders | 03/16/2015 | 04/09/2015 | Friday Ofoegbu | CT D08 - Fontana Southern Regional Laboratory | 28 days | |
1403
