Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994588 DEA: 081H3904 EFIS: 0817000032
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-R20.5/R21.6,R25.5/R30.7
Work Description: CONSTRUCT BUILDING, ROADWAY EXC, JPCP, AND TEMPORARY BARRIER SYSTEM.
Location Description: SAN BERNARDINO COUNTY FROM 0.6 MILE NORTH OF CLEGHORN ROAD UNDERCROSSING TO 0.5 MILE SOUTH OF ROUTE 138 AND FROM 0.5 MILE SOUTH OF TRUCK SAFETY CHECK AREA TO 0.4 MILE NORTH OF OAK HILL ROAD OVERCROSSING
Contractor Name: POWELL CONSTRUCTORS INC
Contractor Address: 8555 BANANA AVE, FONTANA, CA 92335
Resident Engineer: Mauricio Santa Cruz Structure Rep.: Oluwatayo (Tayo) Ogeyemi
DIME Sample ID: 2024-04-26-35
TL Number from the TL Form: 1059-SC1
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 Core
Sample Taken Date: 04/26/2024
Date that the sample was received by the laboratory/organization performing the testing: 05/06/2024
The quantity of what the sample constitutes: 3
A brief description of the sample: Shotcrete Cores
From where was the sample collected: Job Site
Laboratory sample identification: 1059-SC1
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: NA
DIME Test ID: 2024-04-26-35-1
Test Method: ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Capped in accordance with ASTM C617 - Sulfur Mortar Cap 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.
