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Sample Record for 2021-09-28-43

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

Project Information

Project ID: 214671 DEA: 07303904 EFIS: 0714000044 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-10-31.2/37.2
Work Description: LANE REPLACEMENT
Location Description: LOS ANGELES COUNTY IN BALDWIN PARK AND WEST COVINA FROM 0.1 MILE EAST OF THE 10/605 SEPARATION TO 0.3 MILE WEST OF CITRUS STREET OVERCROSSING
Contractor Name: Sierra Landscape Development Inc.
Contractor Address: 2209 1/2 Chico Ave., South El Monte CA, 91733
Resident Engineer: Hai Hong Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-09-28-43
TL Number from the TL Form:
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 09/28/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/29/2021
The quantity of what the sample constitutes: 10 CY
A brief description of the sample: JPCPRS
From where was the sample collected: Job Site
Laboratory sample identification: 21-2461
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Security Paving

Material Information

The concrete mix design number: G3-20-CTS-220
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: NA
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: NA
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: 2021-09-28-43-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 817-0387
Data has not been verified.