Field Sample of PCC Sample Card TL-0502
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STATE OF CALIFORNIA - DEPARTMENT OF TRANSPORTATION
FIELD SAMPLE OF PORTLAND CEMENT CONCRETE
SAMPLE CARD
SRL-TL-0502 (REV.9/13)
FIELD SAMPLE OF PORTLAND CEMENT CONCRETE
SAMPLE CARD
SRL-TL-0502 (REV.9/13)
DIME
DIME Sample ID:
2021-03-05-6
CONTR. NO.: 030F2864
EFIS NO.: 0320000123
FED NO.:
DIST. 03
CO. SAC
RT. 99
P.M. 7.92 / 8.4
LIMITS OF WORK: Remove and replace Consumnes River and Consumnes River Overflow bridge
LOCATION OF POUR:
RES. ENG. OR SUPT:
STRUCTURES DEPT. REP.:
ADDRESS
CONTRACTOR GRANITE CONSTRUCTION COMPANY
SOURCE OF MATERIALS
CEMENT:
CERTIFICATE NO.:
FINE AGGREGATE:
SMARA:
COARSE AGGREGATE:
SMARA:
FIELD SAMPLE NO.:
TRUCK NO.:
TICKET NO.:
DATE CAST:
2021-03-05
AMBIENT TEMP.:
CONCRETE TEMP.:
SIZE OF SPECIMEN - INCHES:
CEMENT - LB/CY:
WATER - LB/CY:
SAMPLED From:
Truck
DATE SAMPLED:
2021-03-05
YARDS PLACED AT TIME OF SAMPLING:
ADMIXTURE:
REMARKS: (MANDATORY - PLEASE ATTACH APPROVED MIX DESIGN)
Cylinder Code: 030F2864 - - 28 - 1,2/2; __ __ __ __ 03/05/2021
SAMPLED BY: Angelica Argana
TITLE:
(no data available)
