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Sample Record for 2018-05-10-13

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

Project Information

Project ID: 212680 DEA: 024F5504 EFIS: 0213000005 QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-89-20.9 - 21.2
Work Description: BRIDGE REPLACEMENT WITH PRE-CAST I-GIRDER AND RECONSTRUCT HIGHWAY
Location Description: SISKIYOU COUNTY NEAR MCCLOUD FROM 0.2 MILE SOUTH TO 0.2 MILE NORTH OF MUD CREEK BRIDGE
Contractor Name: STEELHEAD CONSTRUCTORS, INC.
Contractor Address: PO Box 997, Palo Cedro, CA 96073
Resident Engineer: Mike Zdenek Structure Rep.: Ryan Duran

Sample Information

DIME Sample ID: 2018-05-10-13
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 05/10/2018
Date that the sample was received by the laboratory/organization performing the testing: 05/11/2018
The quantity of what the sample constitutes: 2
A brief description of the sample: Concrete Cylinder 6 x 12
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: kiecon

Material Information

The concrete mix design number: k5565545R1
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: unk
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: fabricator
Where the material sample would have been placed if not sampled: Unknown
From Lot No.: Unknown
Bag Lot No.: Unknown

Test Results

Test 1 of 1

DIME Test ID: 2018-05-10-13-1
Test Method: ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Submitted By Organization: CT HQ - QASI Bay Area Field Office
Organization Address: 690 Walnut Avenue, Suite 150,
Organization City: Vallejo
Organization State: CA
Organization Zipcode: 94592
Organization Email: maged.g.armanuse@dot.ca.gov
Organization Phone: (916) 284-6784
Data has not been verified.