Sample Record for 2017-12-06-10
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 210735 DEA: 071193U4 EFIS: 0713000007
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-10-37.2/42.4
Work Description: CONSTRUCT HOV LANES, WIDEN BRIDGES, AND REALIGN RAMPS.
Location Description: IN LA COUNTY FROM CITRUS STREET IN WEST COVINA TO ROUTE 57 IN POMONA
Contractor Name: Guy F. Atkinson
Contractor Address: 18201 Von Karman Ave, Suite #800, IRVINE CA 92612
Resident Engineer: Rodolfo Cao Structure Rep.: David Win
Sample Information
DIME Sample ID: 2017-12-06-10
TL Number from the TL Form: 268080
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 12/06/2017
Date that the sample was received by the laboratory/organization performing the testing: 12/11/2017
The quantity of what the sample constitutes: 2
A brief description of the sample: 6x12
From where was the sample collected: Job Site
Laboratory sample identification: 946-80
Structure unique identifier: RW 2181 FTG
Structure name: Unknown
The fabricator/manufacturer/facility name: ROBERTSONS
Material Information
The concrete mix design number: CM5645
The truck number from where the sample was collected: 629
The batch plant ticket number from where the sample was collected: 101116604
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: LOAD 5
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 |
| 2017-12-06-10-1 | ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens | 12/11/2017 | 01/03/2018 | Jose Guzman | CT D08 - Fontana Southern Regional Laboratory | | |
13438
