Sample Record for 2020-08-04-8
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 212618 DEA: 044G0564 EFIS: 0417000154
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-680-M2.4/M12.4
Work Description: ROADWAY REHAB, BRIDGE REPLACEMENT, RET. WALLS, TOLL SYSTEMS
Location Description: FREMONT AND AT SUNOL FROM MISSION BOULEVARD SEPARATION TO KOOPMAN ROAD UNDERCROSSING
Contractor Name: BAY CITIES PAVING & GRADING, INC.
Contractor Address: 1450 Civic Ct. BLDG B #400, Concord CA, 94520
Resident Engineer: Yannaing Tun Structure Rep.: Jordan Jarosz
Sample Information
DIME Sample ID: 2020-08-04-8
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 Assurance
Type of Material: Concrete
Sample Taken Date: 08/04/2020
Date that the sample was received by the laboratory/organization performing the testing: 08/05/2020
The quantity of what the sample constitutes: 2 - 6x12 cylinders
A brief description of the sample: 6X12 cylinders
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Oldcastle
Material Information
The concrete mix design number: 63
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 0
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Oldcastle Stockton
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test Results
Test 1 of 1
DIME Test ID: 2020-08-04-8-1
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.
