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Sample Record for 2020-01-10-18

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

Project Information

Project ID: 212988 DEA: 080R1604 EFIS: 0812000029 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-40-R50.0/R75.0
Work Description: REGRADE MEDIAN CROSS SLOPES
Location Description: NEAR LUDLOW FROM 0.3 MILES EAST OF CRUCERO ROAD TO 0.4 MILE WEST OF BADGER WASH
Contractor Name: FISHER SAND & GRAVEL CO.
Contractor Address: 1302 W DRIVERS WAY, TEPE, AZ. 85284
Resident Engineer: Thanh Pham Structure Rep.: Leonard Romero

Sample Information

DIME Sample ID: 2020-01-10-18
TL Number from the TL Form: 011020-2
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: 01/10/2020
Date that the sample was received by the laboratory/organization performing the testing: 02/06/2020
The quantity of what the sample constitutes: 2 cyliners
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 991-10
Structure unique identifier:
Structure name: DS 66 Wing Wall
The fabricator/manufacturer/facility name: Robertsons

Material Information

The concrete mix design number: SC675B39
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: NA
Concrete batch plant: Robertsons
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: 10 Cubic Yards
Where the material sample would have been placed if not sampled: DS 66 Wing Wall
From Lot No.: Unknown
Bag Lot No.: Unknown

Test Results

Test 1 of 1

DIME Test ID: 2020-01-10-18-1
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.