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Sample Record for 2021-09-24-13

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

Project Information

Project ID: 215753 DEA: 050N72U4 EFIS: 0520000169 QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-4.4/R7.7
Work Description: Construct High Occupancy Vehicle (HOV) lanes on U.S. Route 101 and rehabilitation - Segment 4B.
Location Description: 101 freeway in Summerland, CA
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 5335 Debbie Road, Santa Barbara, CA 93111
Resident Engineer: Taylor Merlo Structure Rep.: Dave Lewis

Sample Information

DIME Sample ID: 2021-09-24-13
TL Number from the TL Form:
Sample Submitted By Organization: Con-Fab California, LLC
Sample Organization Contact: 661-630-7162
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 09/24/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/27/2021
The quantity of what the sample constitutes: Three Girders
A brief description of the sample: PCC 6''x12'' test cylinder
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Con-Fab California LLC

Material Information

The concrete mix design number: SCCS950F
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 1745
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Casting Bed 1 West
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 4

DIME Test ID: 2021-09-24-13-1
Test Method: ASTM C39-18: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Ave,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: 661-630-7162
Data has not been verified.

Test 2 of 4

DIME Test ID: 2021-09-24-13-2
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Ave,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: 661-630-7162
Data has not been verified.

Test 3 of 4

DIME Test ID: 2021-09-24-13-3
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Ave,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: 661-630-7162
Data has not been verified.

Test 4 of 4

DIME Test ID: 2021-09-24-13-4
Test Method: ASTM C138-17a: Standard Test Method for Density (Unit Weight), Yield, and Air Content (Gravimetric) of Concrete
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Ave,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: 661-630-7162
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.