Sample Record for 2016-02-02-3
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 209217 DEA: 080F5404 EFIS: 0800000136 COOP: 081468
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-91,15-0.0/13.04, 35.64/45.14
Work Description: SR-91 Corridor Improvement Project: Develop approx. 8 miles of tolled express lanes and related improvements within SR 91 between the Riverside/Orange County line and I-15, including transition areas.
Location Description: 08-RIV-91-0.0/13.04; 12-ORA-91-R14.43/R18.91; 08-RIV-15-35.64/45.14
Contractor Name: Atkinson Walsh, Joint Venture
Contractor Address: 1785 Sampson Ave, Corona, CA 92879
Resident Engineer: Richard Hebert Structure Rep.: Cyrus Shahinpar
Sample Information
DIME Sample ID: 2016-02-02-3
TL Number from the TL Form: SRL 389
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: 02/02/2016
Date that the sample was received by the laboratory/organization performing the testing: 02/07/2017
The quantity of what the sample constitutes: 4
A brief description of the sample: 6x12 concrete cylindes
From where was the sample collected: Job Site
Laboratory sample identification: 888-SRL399
Structure unique identifier: Unknown
Structure name: BR 26 BENT 6 TO 9 RETROFIT
The fabricator/manufacturer/facility name: HOLIDAY ROCK
Material Information
The concrete mix design number: 4H40X006
The truck number from where the sample was collected: 370
The batch plant ticket number from where the sample was collected: 118058230
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: Discharge from concrete truck into wheelbarrow.
Where the material sample would have been placed if not sampled: Unknown
From Lot No.: Unknown
Bag Lot No.: Unknown
Test Results
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| 2016-02-02-3-1 | ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens | 02/09/2017 | 02/16/2016 | Matthew Clayton | CT D08 - Fontana Southern Regional Laboratory | | |
| 2016-02-02-3-2 | ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens | 02/09/2017 | 03/01/2016 | Matthew Clayton | CT D08 - Fontana Southern Regional Laboratory | | |
73727373
