Sample Record for 2020-03-03-6
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 9999 DEA: 00000000 EFIS: 0000000000 COOP: 99999333399 MINOR: 333333 Permit Numbers: 555555 0400NRT0000
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: YYZ
Contractor Address: 1234 address, Sacramento, CA 95824
Resident Engineer: RE_first RE_last Structure Rep.: SR_First SR_Last
Sample Information
DIME Sample ID: 2020-03-03-6
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QAM Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7266
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 03/03/2020
Date that the sample was received by the laboratory/organization performing the testing: 03/03/2020
The quantity of what the sample constitutes: 250cy
A brief description of the sample: structural concrete
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Cemex Lemoncove
Material Information
The concrete mix design number: 123456
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: 123445
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: CHUTE FROM TRUCK
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: 2020-03-03-6-1
Test Method: ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Verified Date: 05/01/2020
Date Tested: 05/01/2020
Submitted By Organization: CT HQ - QAM Sacramento Field Laboratory
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Unit system used?
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US Units
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Number of specimens
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1
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Test performed
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With no density determined
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Capped in accordance with?
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ASTM C617/CTM521
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Average diameter of cylinder 1
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3.62 in
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Compressive strength of cylinder (to nearest 10 psi)
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1000 psi
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Maximum load on cylinder 1
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2560 lb
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Type of fracture pattern of cylinder 1
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1
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Comment on any defect in either specimen or caps (Max 250 Characters)
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no data
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Correction factor for cylinder 1
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1
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Age of specimen
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59 days
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Age of specimen in hours
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no data
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