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Sample Record for 2013-06-28-5507

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

Project Information

Project ID: 8127 DEA: 080N5904 EFIS: 0800000533 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-40-R85.2
Work Description: CONSTRUCT PC/PS BULB-TEE GIRDER BRIDGE
Location Description: SAN BERNARDINO COUNTY NEAR ESSEX AT VAN WINKLE WASH BRIDGE
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: P.O. Box 50085, Watsonville, CA 95077
Resident Engineer: Khoa Nguyen Structure Rep.: Ching Chuang

Sample Information

DIME Sample ID: 2013-06-28-5507
TL Number from the TL Form:
Sample Submitted By Organization: SCST, LLC.
Sample Organization Contact: (619) 280-4321
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 06/28/2013
Date that the sample was received by the laboratory/organization performing the testing: 06/29/2013
The quantity of what the sample constitutes: 4 cylinders
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier: Abutment no. 1 Pile no. 3
Structure name: Abutment no. 1 Pile no. 3
The fabricator/manufacturer/facility name: Hi-Grade Concrete Supplier

Material Information

The concrete mix design number: HG53401R
The truck number from where the sample was collected: 193
The batch plant ticket number from where the sample was collected: 810383
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Abutment no. 1 Pile no. 3 - Full Height
Where the material sample would have been placed if not sampled: Abutment no. 1 Pile no. 3
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 6

DIME Test ID: 2013-06-28-5507-1
Test Method: CTM 504-June 2010: Method of Test for Determining Air Content of Freshly Mixed Concrete by the Pressure Method
Verified Date: 07/09/2013
Date Tested: 06/28/2013
Submitted By Organization: SCST, LLC.
Organization Address: 6280 Riverdale Street,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92120
Organization Email: dhicks@scst.com
Organization Phone: (619) 280-4321
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Air Content 1.5 %

Test 2 of 6

DIME Test ID: 2013-06-28-5507-2
Test Method: CTM 556-June 2010: Method of Test for Slump of Fresh Portland Cement Concrete
Verified Date: 07/09/2013
Date Tested: 06/28/2013
Submitted By Organization: SCST, LLC.
Organization Address: 6280 Riverdale Street,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92120
Organization Email: dhicks@scst.com
Organization Phone: (619) 280-4321
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Slump 5 in

Test 3 of 6

DIME Test ID: 2013-06-28-5507-3
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 07/09/2013
Date Tested: 06/28/2013
Submitted By Organization: SCST, LLC.
Organization Address: 6280 Riverdale Street,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92120
Organization Email: dhicks@scst.com
Organization Phone: (619) 280-4321
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens no data
Cylinder Age 7 days
Break Description of Cylinder 1 (if not 'cone') no data

Test 4 of 6

DIME Test ID: 2013-06-28-5507-4
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 07/29/2013
Date Tested: 07/26/2013
Submitted By Organization: SCST, LLC.
Organization Address: 6280 Riverdale Street,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92120
Organization Email: dhicks@scst.com
Organization Phone: (619) 280-4321
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens no data
Cylinder Age 28 days
Break Description of Cylinder 1 (if not 'cone') no data

Test 5 of 6

DIME Test ID: 2013-06-28-5507-5
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 07/29/2013
Date Tested: 07/26/2013
Submitted By Organization: SCST, LLC.
Organization Address: 6280 Riverdale Street,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92120
Organization Email: dhicks@scst.com
Organization Phone: (619) 280-4321
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens no data
Cylinder Age 28 days
Break Description of Cylinder 1 (if not 'cone') no data

Test 6 of 6

DIME Test ID: 2013-06-28-5507-6
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 07/29/2013
Date Tested: 07/26/2013
Submitted By Organization: SCST, LLC.
Organization Address: 6280 Riverdale Street,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92120
Organization Email: dhicks@scst.com
Organization Phone: (619) 280-4321
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens no data
Cylinder Age 28 days
Break Description of Cylinder 1 (if not 'cone') no data

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.