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Sample Record for 2017-10-04-5

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

Project Information

Project ID: 211070 DEA: 080Q3004 EFIS: 0800020191 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-138-R17.1/R19.2
Location Description: Near Hesperia from 1.9 mi East of Route 15 to 0.1 mi West of Summit Post Office Road to realign sections of State Route 138
Contractor Name: Skanska Civil USA
Contractor Address: 1995 Agua Mansa Road, Riverside, CA 92509
Resident Engineer: Amgad Benjamin Structure Rep.: Tim Flores

Sample Information

DIME Sample ID: 2017-10-04-5
TL Number from the TL Form: 20171004-B
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 10/04/2017
Date that the sample was received by the laboratory/organization performing the testing: 10/11/2017
The quantity of what the sample constitutes: 2
A brief description of the sample: 6x12 concrete cylindes
From where was the sample collected: Job Site
Laboratory sample identification: 955-04B
Structure unique identifier: Double Drain Creek BridgeUnknown
Structure name: Double Drain Creek Bridge
The fabricator/manufacturer/facility name: Robertsons Lucern Valley

Material Information

The concrete mix design number: RRM16065
The truck number from where the sample was collected: 1962
The batch plant ticket number from where the sample was collected: 2872485
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: chute
Where the material sample would have been placed if not sampled: Double Drain Creek Bridge 2nd Deck pour
From Lot No.: Unknown
Bag Lot No.: Unknown

Test Results

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
2017-10-04-5-1ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens10/11/201710/18/2017Matthew ClaytonCT - Southern Regional Laboratory