Sample Record for 2020-04-30-21
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 213856 DEA: 112888U4 EFIS: 1118000199
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-11,125,905-Various
Work Description: CONSTRUCT FREEWAY TO FREEWAY CONNECTORS AND 4-LANE HIGHWAY FACILITY
Location Description: SAN DIEGO COUNTY AT VARIOUS LOCATIONS
Contractor Name: Skanska USA Civil West CA
Contractor Address: 1995 Agua Mansa Road, Riverside, CA 92509
Resident Engineer: Carlos Covarrubias Structure Rep.: Wade Durant
Sample Information
DIME Sample ID: 2020-04-30-21
TL Number from the TL Form:
Sample Submitted By Organization: CT - Unassigned/General Field Laboratory
Sample Organization Contact: 5625005861
Type of Sample: Verification
Type of Material: Concrete
Sample Taken Date: 04/30/2020
Date that the sample was received by the laboratory/organization performing the testing: 05/05/2020
The quantity of what the sample constitutes: 10
A brief description of the sample: PCC
From where was the sample collected: Source
Laboratory sample identification: 0261
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Robertsons Otay Plant
Material Information
The concrete mix design number: RM20016R
The truck number from where the sample was collected: 1325
The batch plant ticket number from where the sample was collected: 5172944
Concrete batch plant: Robertsons Otay
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: Back of 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 3
DIME Test ID: 2020-04-30-21-1
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Submitted By Organization: CT - Unassigned/General 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
Data has not been verified.
Test 2 of 3
DIME Test ID: 2020-04-30-21-2
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Submitted By Organization: CT - Unassigned/General 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
Data has not been verified.
Test 3 of 3
DIME Test ID: 2020-04-30-21-3
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Submitted By Organization: CT - Unassigned/General 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
Data has not been verified.
