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Sample Record for 2021-12-13-32

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

Project Information

Project ID: 211260 DEA: 072159U4 EFIS: 0715000160 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,ORA-5-0.0/1.5, 44.3/44.4
Work Description: CONSTRUCT HOV LANES AND MIX FLOW LANES.
Location Description: LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 TOWNSGATE RD. SUITE 200, WESTLAKE VILLAGE, CA 91361
Resident Engineer: George Saker Structure Rep.: Danny Lalonde

Sample Information

DIME Sample ID: 2021-12-13-32
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: Acceptance
Type of Material: Concrete
Sample Taken Date: 12/13/2021
Date that the sample was received by the laboratory/organization performing the testing: 12/13/2021
The quantity of what the sample constitutes: 700 cy
A brief description of the sample: NB I-5 Mainline lane#1 sta.73+85
From where was the sample collected: Job Site
Laboratory sample identification: 21-2953
Structure unique identifier: 21-2953
Structure name: NB I5 mainline
The fabricator/manufacturer/facility name: Security Paving batch plant

Material Information

The concrete mix design number: G3-19-PCC-001
The truck number from where the sample was collected: 10
The batch plant ticket number from where the sample was collected: 21044
Concrete batch plant: Security Paving Company
The fabricator/manufacturer designation for the sample: SECURITY PAVING
A detailed description of where the material sample was collected: NB I-5 Mainline lane1
Where the material sample would have been placed if not sampled: jobsite
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 1

DIME Test ID: 2021-12-13-32-1
Test Method: CTM 523-May 2020: Method of Test for Flexural Strength of 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.