Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212534 DEA: 010H4904 EFIS: 0117000229
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM,HUM-101-29.4, 29.40
Work Description: Slide and roadway repairs
Location Description:
Contractor Name: INTERMOUNTAIN SLURRY SEAL
Contractor Address: 1005 TERMINAL WAY SUITE 220, RENO, NEVADA 89502
Resident Engineer: Mark Gorona Structure Rep.: Peter O'Donnell
DIME Sample ID: 2018-07-18-21
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT D01 - District 1 Materials Laboratory
Sample Organization Contact: (707) 496-0974
Type of Sample: Verification
Type of Material: Concrete
Sample Taken Date: 07/18/2018
Date that the sample was received by the laboratory/organization performing the testing: 08/17/2018
The quantity of what the sample constitutes: unknown
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification: Unknown
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: Unknown
The concrete mix design number: 01
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: 01
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: Unknown
From Lot No.: Unknown
Bag Lot No.: Unknown
DIME Test ID: 2018-07-18-21-1
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 08/01/2018
Date Tested: 08/15/2018
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1726 Albee Street,
Organization City: Eureka
Organization State: CA
Organization Zipcode: 95501
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
General Comments for this Test:
Test Result Compliance: not applicable
Additional Comments When Verified:
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Cross sectional area of cylinder 1
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28.27 in^2
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Cross sectional area of cylinder 2
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28.27 in^2
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Compressive strength (to nearest 10 psi)
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3390 psi
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Comment on any defect in either specimen or caps (Max 250 Characters)
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no data
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Correction factor for cylinder 1
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1
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Age of specimen
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5 days
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