Sample Record for 2017-06-17-1
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 211671 DEA: 07281504 EFIS: 0700000552
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,VEN-101-29.3/38.2,0.0/1.2
Work Description: CONSTRUCT STORM WATER TREATMENT SYSTEMS.
Location Description: LOS ANGELES AND VENTURA COUNTIES AT VARIOUS LOCATIONS
Contractor Name: C.A. Rasmussen Inc
Contractor Address: 28548 Livingston Ave, Valencia, CA 91355
Resident Engineer: VENKATARAMAN KALYANAKRISHNAN Structure Rep.: Ray Ranjkesh
Sample Information
DIME Sample ID: 2017-06-17-1
TL Number from the TL Form: 193656
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: 06/17/2017
Date that the sample was received by the laboratory/organization performing the testing: 06/12/2017
The quantity of what the sample constitutes: 2
A brief description of the sample: 6 X 12 Concrete Cylinder
From where was the sample collected: Job Site
Laboratory sample identification: 960-56
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: NOT PROVIDED
Material Information
The concrete mix design number: S63061
The truck number from where the sample was collected: NOT PROVIDED
The batch plant ticket number from where the sample was collected: NOT PROVIDED
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: LOAD 2
Where the material sample would have been placed if not sampled: LOCATION 20 AUSTIN VAULT
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 |
| 2017-06-17-1-1 | ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens | 06/15/2017 | 07/15/2017 | Matthew Clayton | CT D08 - Fontana Southern Regional Laboratory | | |
8801
