Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 213763 DEA: 060Q19A4 EFIS: 0613000152
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-58-R99.0/R100.3
Work Description: WIDEN SHOULDERS AND REPLACE BRIDGES
Location Description: KERN COUNTY NEAR TEHACHAPI FROM 0.5 MILE WEST TO 0.8 MILE EAST OF SAND CANYON UNDERCROSSING
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 3005 James Road, Bakersfield, CA 93308
Resident Engineer: Hin Hartanto Structure Rep.: Jegbefume Adodo
DIME Sample ID: 2019-09-27-18
TL Number from the TL Form: 20190927
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 09/27/2019
Date that the sample was received by the laboratory/organization performing the testing: 10/07/2019
The quantity of what the sample constitutes: 2
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 994-927
Structure unique identifier:
Structure name: Abutment 2 five piles within footing footprint
The fabricator/manufacturer/facility name: readymix
The concrete mix design number: 3H40G004
The truck number from where the sample was collected: 307
The batch plant ticket number from where the sample was collected: 112016600
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: granite
A detailed description of where the material sample was collected: truck
Where the material sample would have been placed if not sampled: Abutment 2 five piles within footing footprint
From Lot No.: Unknown
Bag Lot No.: Unknown
DIME Test ID: 2019-09-27-18-1
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 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.
