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

Sample Record for 2017-04-27-1


Project Information

Project ID: 211260 DEA: 072159U4 EFIS: 0715000160 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,ORA-5-0.0/1.5, 44.3/44.4
Work Description: CONSTRUCT HOV LANES AND MIX FLOW LANES.
Location Description: LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
Contractor Name: SECURITY PAVING COMPANY, INC. Contractor Address: 3075 TOWNSGATE RD. SUITE 200
Resident Engineer: George Saker Structure Rep.: Lalonde, Danny

Sample Information

DIME Sample ID: 2017-04-27-1
TL Number from the TL Form:
Sample Submitted By Organization: CT SC Sub-unit 3671-106
Sample Organization Contact:
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 04/27/2017
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 250 cy
A brief description of the sample: Portland Cement Concrete
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:

Material Information

The concrete mix design number: 123456
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 123654789
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: wheelbarrow
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 1

DIME Test ID: 2017-04-27-1-2
Test Method: ASTM C231-17a: Standard Test Method for Air Content of Freshly Mixed Concrete by the Pressure Method
Verified Date: 04/27/2017
Date Tested: 04/27/2017
Submitted By Organization: CT SC Sub-unit 3671-106
Organization Address:
Test General Comments:
Additional Comments When Verified:
Air content 1.4 %
Air content of the mortar fraction no data