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Sample Record for 2020-02-13-23

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

Project Information

Project ID: 212300 DEA: 044G3804 EFIS: 0412000463 QA Service Level: 1
DIST-CO-RTE-PM: 04-SON-116-30.9/31.4
Work Description: Construct Bridge, Retaining Walls, Traffic Signal
Location Description: SONOMA COUNTY NEAR COTATI FROM 0.3 MILE EAST OF HESSEL ROAD TO 0.1 MILE EAST OF BARTLESON ROAD
Contractor Name: GHILOTTI CONSTRUCTION COMPANY
Contractor Address: 246 GHILOTTI AVENUE, SANTA ROSA, CA 95407
Resident Engineer: Leonard Brajnikoff Structure Rep.: Cliff Law

Sample Information

DIME Sample ID: 2020-02-13-23
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: Quality Control
Type of Material: Concrete
Sample Taken Date: 02/13/2020
Date that the sample was received by the laboratory/organization performing the testing: 02/14/2020
The quantity of what the sample constitutes: 2 - 6x12 cylinders
A brief description of the sample: 6"x12" Cylinders
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Kie-Con Antioch

Material Information

The concrete mix design number: K5110
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: 00000
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: Concrete sample from wheelbarrow
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: 2020-02-13-23-1
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 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.