Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 209175 DEA: 030F2204 EFIS: 0300000072
QA Service Level: 1
DIST-CO-RTE-PM: 03-ED-50-R30.7/R31.7
Work Description: REPLACE BRIDGE.
Location Description: SLY PARK UNDERCROSSING
Contractor Name: VIKING CONSTRUCTION COMPANY, INC.
Contractor Address: P.O. Box 1508 , Rancho Cordova, CA 95741
Resident Engineer: Jarrett Woodruff Structure Rep.: Brandon Miller
DIME Sample ID: 2014-06-18-12302410
TL Number from the TL Form:
Sample Submitted By Organization: Con-Fab California Corporation - Lathrop
Sample Organization Contact: (209) 249-4700
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 06/18/2014
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 2
A brief description of the sample: 6X12 cylinders
From where was the sample collected: Source
Laboratory sample identification: 2014-06-18-12-30-2410
Structure unique identifier: SG1.2 SG1.2 Girder
Structure name: Sly Park Rd UC
The fabricator/manufacturer/facility name: Con-Fab California Corporation
The concrete mix design number: V98-25AF
The truck number from where the sample was collected: 2
The batch plant ticket number from where the sample was collected: 4434
Concrete batch plant: BP3
The fabricator/manufacturer designation for the sample: SLY061814
A detailed description of where the material sample was collected: Bed 1A at 2nd truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2014-06-18-12302410-1
Test Method: ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Capped in accordance with ASTM C617/CTM521 Cured in accordance with ASTM C511
Verified Date: 04/20/2022
Date Tested: 07/16/2014
Submitted By Organization: Con-Fab California Corporation - Lathrop
Organization Address: 1910 Lathrop Road,
Organization City: Lathrop
Organization State: CA
Organization Zipcode: 95330
Organization Email: dannyc@confabca.com
Organization Phone: (209) 249-4717
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Unit system used?
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US Units
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Number of specimens
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2
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Test performed
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With density determined by dimension measurements
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Average cylinder density (to nearest 1 pcf)
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143 lb/ft^3
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Average diameter of cylinder 1
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6.00 in
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Average diameter of cylinder 2
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6.00 in
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Comment on any defect in either specimen or caps (Max 250 Characters)
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no data
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