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

Sample Record for 2013-05-06-4114

Project Information

Project ID: 2557 DEA: 050E9604 EFIS: 0500000043 QA Service Level: 1
DIST-CO-RTE-PM: 05-MON-1-21.3/21.6
Work Description: Construct Bridge And Rock Shed.
Location Description: In Monterey County near Lucia from 0.6 mile north of Limekiln Creek Bridge to 1.4 miles south of Lucia
Contractor Name: Golden State Bridge, Inc Contractor Address: 901 Howe Road
Resident Engineer: Charlie Hench Structure Rep.: Walker, Wayne

Sample Information

DIME Sample ID: 2013-05-06-4114
TL Number from the TL Form:
Sample Submitted By Organization: ZZCT DIME Development Laboratory A - Bellflower
Sample Organization Contact: 213-555-1212
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 05/06/2013
Date that the sample was received by the laboratory/organization performing the testing: 03/22/2013
The quantity of what the sample constitutes: two cylinders
A brief description of the sample: concrete from the bridge deck
From where was the sample collected: Other
Laboratory sample identification: 8301
Structure unique identifier: Pitkins Curve Bridge
Structure name: Pitkins Bridge

Material Information

The concrete mix design number: 555
The truck number from where the sample was collected: 444
The batch plant ticket number from where the sample was collected: 10123
Concrete batch plant: 23
The fabricator/manufacturer designation for the sample: 555
A detailed description of where the material sample was collected: Collected during pour into the bridge deck
Where the material sample would have been placed if not sampled: bridge deck
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 3

DIME Test ID: 2013-05-06-4114-1
Test Method: ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Capped in accordance with ASTM C617/CTM521
Verified Date: 05/07/2013
Date Tested: 05/07/2013
Submitted By Organization: ZZCT DIME Development Laboratory A - Bellflower
Organization Address: 1234 Norwalk Blvd
Test General Comments: N/A
Additional Comments When Verified:
Unit system used? US Units
Number of specimens 2
Test performed no data
Comment on any defect in either specimen or caps (Max 250 Characters) N/A

Test Results

Test 2 of 3

DIME Test ID: 2013-05-06-4114-2
Test Method: ASTM C143-10a: Standard Test Method for Slump of Hydraulic-Cement Concrete
Data has not been verified.

Test Results

Test 3 of 3

DIME Test ID: 2013-05-06-4114-3
Test Method: ASTM C173-16: Standard Test Method for Air Content of Freshly Mixed Concrete by the Volumetric Method
Data has not been verified.