Sample Record for 2018-06-11-10
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 209694 DEA: 080J0704 EFIS: 0800000282
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-215-0.6/1.7
Work Description: (Alternative Delivery) The CMGC project will reconstruct and improve interchange of I-215 and Barton Road in the City of Grand Terrace, CA.
Location Description: Grade separation at Intersection of I-215 and Barton Road near Grand Terrace, CA. ? On I-215 between I-10 and SR-60.
Contractor Name: Myers / Rados-Southern California Jobsite Office
Contractor Address: 12210 Michigan St., Suite D, Grand Terrace, CA 92313
Resident Engineer: Fereydoon Alipanah Structure Rep.: Tim Flores
Sample Information
DIME Sample ID: 2018-06-11-10
TL Number from the TL Form: 975-611
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: 06/11/2018
Date that the sample was received by the laboratory/organization performing the testing: 06/18/2018
The quantity of what the sample constitutes: 2
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 975-611
Structure unique identifier: ABUTMENT 4 RIGHT RETANING WALL
Structure name: ABUTMENT 4 RIGHT RETANING WALL
The fabricator/manufacturer/facility name: ROBERTSON
Material Information
The concrete mix design number: SC590B38
The truck number from where the sample was collected: 142
The batch plant ticket number from where the sample was collected: 3592864
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: MYERS
A detailed description of where the material sample was collected: Chute
Where the material sample would have been placed if not sampled: ABUTMENT 4 RIGHT RETANING WALL
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 |
| 2018-06-11-10-1 | ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens | 07/10/2018 | 07/09/2018 | Matthew Clayton | CT D08 - Fontana Southern Regional Laboratory | | |
15973
