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Sample Record for 2017-01-31-9

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 209141 DEA: 07215954 EFIS: 0700001835 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-0.0/7.6
Work Description: WIDENING FREEWAY AND RECONSTRUCT OVERHEAD AND OVERCROSSING STRUCTURES
Location Description: LOS ANGELES COUNTY IN LA MIRADA, SANTA FE SPRINGS, NORWALK AND DOWNEY FROM ORANGE COUNTY/LOS ANGELES COUNTY LIMIT LINES TO 0.7 MILE NORTH OF ROUTE 605
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 13170 TELFAIR AVENUE, SYLMAR, CA 91342
Resident Engineer: Thang Ton Structure Rep.: Amare Tsagie

Sample Information

DIME Sample ID: 2017-01-31-9
TL Number from the TL Form: Unknown
Sample Submitted By Organization: G3 Quality, Incorporated - Cerritos
Sample Organization Contact: (562) 321-9840
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 01/31/2017
Date that the sample was received by the laboratory/organization performing the testing: 02/01/2017
The quantity of what the sample constitutes: 6
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification: Set 1
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: Jobsite

Material Information

The concrete mix design number: G3-15-3600
The truck number from where the sample was collected: Load 2
The batch plant ticket number from where the sample was collected: 2
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Set 1
A detailed description of where the material sample was collected: RW-91 Footing
Where the material sample would have been placed if not sampled: RTE 91 Footing
From Lot No.: Unknown
Bag Lot No.: Unknown

Test Results

Test 1 of 5

DIME Test ID: 2017-01-31-9-1
Test Method: ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: (562) 321-9840
This test has been superseded on 03/01/2017.
Reason: corrected

Test 2 of 5

DIME Test ID: 2017-01-31-9-2
Test Method: ASTM C1064-12: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: (562) 321-9840
This test has been superseded on 03/01/2017.
Reason: corrected

Test 3 of 5

DIME Test ID: 2017-01-31-9-3
Test Method: ASTM C138-17a: Standard Test Method for Density (Unit Weight), Yield, and Air Content (Gravimetric) of Concrete
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: (562) 321-9840
This test has been superseded on 03/01/2017.
Reason: corrected

Test 4 of 5

DIME Test ID: 2017-01-31-9-4
Test Method: ASTM C143-15a: Standard Test Method for Slump of Hydraulic-Cement Concrete
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: (562) 321-9840
This test has been superseded on 03/01/2017.
Reason: corrected

Test 5 of 5

DIME Test ID: 2017-01-31-9-5
Test Method: ASTM C173-16: Standard Test Method for Air Content of Freshly Mixed Concrete by the Volumetric Method
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: (562) 321-9840
This test has been superseded on 03/01/2017.
Reason: corrected