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Sample Record for 2021-01-21-30

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

Project Information

Project ID: 215129 DEA: 050N73U4 EFIS: 0520000166 QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-7.3/9.6
Work Description: Segment 4C - Summerland: Construct HOV lanes and rehabilitation. Source inspection of sign structure trusses, lighting structures, steel soldier piles, epoxy coated rebar, headed rebar, welded hoops, column pins.
Location Description: SUMMERLAND FROM 0.2 MILES NORTH OF PARDARO LANE OVERCROSSING TO SAN YSIDRO CREEK BRIDGE
Contractor Name: Granite Construction
Contractor Address: PO Box 6744, Santa Barbara , CA 93111
Resident Engineer: Tristan Gebhart Structure Rep.: Hernandez, Bernardo

Sample Information

DIME Sample ID: 2021-01-21-30
TL Number from the TL Form:
Sample Submitted By Organization: Sequoia Consultant
Sample Organization Contact: 1 (714) 974-6316
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 01/21/2021
Date that the sample was received by the laboratory/organization performing the testing: 01/22/2021
The quantity of what the sample constitutes: 100 cy
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name: Retaining Wall 104 Footing
The fabricator/manufacturer/facility name: Hanson Goleta

Material Information

The concrete mix design number: 63511N0P
The truck number from where the sample was collected: 689
The batch plant ticket number from where the sample was collected: 546045
Concrete batch plant: Hanson Goleta
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: truck chute
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: 2021-01-21-30-1
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Submitted By Organization: Sequoia Consultant
Organization Address: 361 W Grove Ave,
Organization City: Orange
Organization State: CA
Organization Zipcode: 92865
Organization Email: sranjan@sequoiacon.com
Organization Phone: 1 (714) 974-6316
Data has not been verified.

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.