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Sample Record for 2017-06-01-25

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

Project Information

Project ID: 211690 DEA: 042A3204 EFIS: 0400000817 QA Service Level: 1
DIST-CO-RTE-PM: 04-NAP-121-9.2/9.4
Work Description: ROADWAY WIDENING, BRIDGE REPLACEMENT, CREEK GRADING
Location Description: NAPA COUNTY IN NAPA AT SILVERADO TRAIL ROAD
Contractor Name: GHILOTTI CONSTRUCTION COMPANY
Contractor Address: 2301 Kerner Blvd Ste. E, San Rafael, CA 94901
Resident Engineer: Fernando Dos Santos Structure Rep.: Chris Moulton

Sample Information

DIME Sample ID: 2017-06-01-25
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: 06/01/2017
Date that the sample was received by the laboratory/organization performing the testing: 06/02/2017
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: k4060421
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: 2017-06-01-25-1
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.