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Sample Record for 2019-01-28-14

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

Project Information

Project ID: 213337 DEA: 024F5404 EFIS: 0213000004 QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-5-R15.3/R16.5
Work Description: BRIDGE REPLACEMENT - SOUTHBOUND ONLY
Location Description: SISKIYOU COUNTY NEAR WEED FROM 0.1 MILE SOUTH OF DEETZ ROAD UNDERCROSSING TO 0.6 MILE NORTH OF BLACK BUTTE OVERHEAD 02-0004L
Contractor Name: J.F. SHEA CONSTRUCTION
Contractor Address: P.O. BOX 494519, REDDING, CA 96049-4519
Resident Engineer: Jeff Steppat Structure Rep.: Andy O'Sullivan

Sample Information

DIME Sample ID: 2019-01-28-14
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Informational
Type of Material: Concrete
Sample Taken Date: 01/28/2019
Date that the sample was received by the laboratory/organization performing the testing: 01/29/2019
The quantity of what the sample constitutes: 2
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: KieCon

Material Information

The concrete mix design number: K556554522
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: 2019-01-28-14-1
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.