Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 209247 DEA: 024E6304 EFIS: 0212000010
QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-96-56.0
Work Description: FISH PASSAGE - REPLACE CULVERT WITH BRIDGE
Location Description: SISKIYOU COUNTY NEAR SEIAD VALLEY AT 3.5 MILES EAST OF THOMPSON CREEK BRIDGE
Contractor Name: Stewart Engineering, Inc.
Contractor Address: P.O. Box 990010, Redding, CA 96099-0010
Resident Engineer: Mark Loader Structure Rep.: Chris Brace
DIME Sample ID: 2014-08-14-20
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: Informational
Type of Material: Concrete
Sample Taken Date: 08/14/2014
Date that the sample was received by the laboratory/organization performing the testing: 08/06/2014
The quantity of what the sample constitutes: 4 Cylinders
A brief description of the sample: Precast abutment 4 and 6
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: KieCon
The concrete mix design number: K2540267
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 11111
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Open top truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2014-08-14-20-1
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.
DIME Test ID: 2014-08-14-20-2
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.
DIME Test ID: 2014-08-14-20-3
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.
