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Sample Record for 2021-01-30-9

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

Project Information

Project ID: 213970 DEA: 080K1214 EFIS: 0815000245 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-12.5/14.8
Work Description: REPLACE PCC PAVEMENT WITH JPCP AND PRECAST JOINTED CONCRETE PAVEMENT.
Location Description: SAN BERNARDINO COUNTY IN FONTANA AND NEAR DEVORE FROM 0.3 MILE SOUTH OF SIERRA AVENUE UNDERCROSSING TO GLEN HELEN PARKWAY UNDERCROSSING
Contractor Name: OHL USA, INC
Contractor Address: 1920 MAIN STREET STE 310, Irvine, CA 92614
Resident Engineer: Vu Thanh Nguyen Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-01-30-9
TL Number from the TL Form:
Sample Submitted By Organization: Sequoia Consultant
Sample Organization Contact: 1 (714) 974-6316
Type of Sample: Informational
Type of Material: Concrete
Sample Taken Date: 01/30/2021
Date that the sample was received by the laboratory/organization performing the testing: 01/30/2021
The quantity of what the sample constitutes: project
A brief description of the sample: CTE
From where was the sample collected: Job Site
Laboratory sample identification: C013021-100A-100B-100C-100D
Structure unique identifier:
Structure name: SB I-15 Fontana
The fabricator/manufacturer/facility name: Cemex Lytle Creek

Material Information

The concrete mix design number: 1553950
The truck number from where the sample was collected: 3
The batch plant ticket number from where the sample was collected: 1
Concrete batch plant: Cemex Lytle Creek
The fabricator/manufacturer designation for the sample: Batch
A detailed description of where the material sample was collected: Discharge chute from back of truck
Where the material sample would have been placed if not sampled: SB I15 shoulder
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 4

DIME Test ID: 2021-01-30-9-1
Test Method: AASHTO T336-15: Standard Method of Test for Coefficient of Thermal Expansion of Hydraulic Cement Concrete
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.

Test 2 of 4

DIME Test ID: 2021-01-30-9-2
Test Method: AASHTO T336-15: Standard Method of Test for Coefficient of Thermal Expansion of Hydraulic Cement Concrete
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.

Test 3 of 4

DIME Test ID: 2021-01-30-9-3
Test Method: AASHTO T336-15: Standard Method of Test for Coefficient of Thermal Expansion of Hydraulic Cement Concrete
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.

Test 4 of 4

DIME Test ID: 2021-01-30-9-4
Test Method: AASHTO T336-15: Standard Method of Test for Coefficient of Thermal Expansion of Hydraulic Cement Concrete
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.