Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 210837 DEA: 080J0804 EFIS: 0800000283 COOP: 081625
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-15-34.7/51.6
Work Description: (Alternative Delivery) DESIGN-BUILD OF THE INTERSTATE 15 EXPRESS LANES PROJECT
Location Description: Riverside County and SBD-15-0.0/1.3
Contractor Name: Skanska-Ames, Joint Venture
Contractor Address: 1801 California Avenue, Corona, CA 92881
Resident Engineer: Roy Fisher (reports) Structure Rep.: Roy Fisher
DIME Sample ID: 2018-11-27-7
TL Number from the TL Form: 17
Sample Submitted By Organization: CT D08 - Barstow Field Laboratory 1
Sample Organization Contact: (760) 252-9216
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 11/27/2018
Date that the sample was received by the laboratory/organization performing the testing: 11/29/2018
The quantity of what the sample constitutes: 4
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Manufacturer
Laboratory sample identification: 974-17
Structure unique identifier: at the plant
Structure name: at the plant
The fabricator/manufacturer/facility name: robertsont redland
The concrete mix design number: SC270N31
The truck number from where the sample was collected: na
The batch plant ticket number from where the sample was collected: 098878
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: SKANSKA AMES
A detailed description of where the material sample was collected: 4 cy
Where the material sample would have been placed if not sampled: at the plant
From Lot No.: Unknown
Bag Lot No.: Unknown
DIME Test ID: 2018-11-27-7-1
Test Method: ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Capped in accordance with ASTM C617/CTM521
Submitted By Organization: CT D08 - Barstow Field Laboratory 1
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
Data has not been verified.
