Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214486 DEA: 080K1224 EFIS: 0815000244
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-R28.6/37.5
Work Description: REHBILIATATE EXISTING MAINLINE AND RAMP PAVEMENT
Location Description: SAN BERNARDINO COUNTY IN HESPERIA AND VICTORVILLE FROM OAK HILL ROAD OVERCROSSING TO 0.1 MILE SOUTH OF BEAR VALLEY ROAD OVERCROSSING
Contractor Name: SULLY - MILLER CONTRACTING COMPANY
Contractor Address: 135 S STATE COLLEGE BLVD. 400, BREA, CA 92821
Resident Engineer: Larry J Canuti Structure Rep.: Taghreed Al-khateeb
DIME Sample ID: 2023-11-14-66
TL Number from the TL Form: 1042-1114
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: 11/14/2023
Date that the sample was received by the laboratory/organization performing the testing: 11/14/2023
The quantity of what the sample constitutes: 6
A brief description of the sample: 6X12
From where was the sample collected: Job Site
Laboratory sample identification: 1042-1114
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: SULLY Miller
The concrete mix design number: G3-22-PCC-273
The truck number from where the sample was collected: Not Provided on TL
The batch plant ticket number from where the sample was collected: 21
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: SB I15 STAGE 2A JPCP LN 1STA 131.65 - 131.45
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2023-11-14-66-1
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
Verified Date: 12/26/2023
Date Tested: 12/26/2023
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
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 density determined by dimension measurements
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Average cylinder density (to nearest 1 pcf)
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148 lb/ft^3
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Average diameter of cylinder 1
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5.99 in
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Average diameter of cylinder 2
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5.98 in
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Average diameter of cylinder 3
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5.99 in
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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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