Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993236 DEA: 051K0504 EFIS: 0518000114
QA Service Level: 1
DIST-CO-RTE-PM: 05-MON-1-55.7/55.9
Work Description: CONSTRUCT EARTH RETAINING SYSTEM WITH CIDH PILE & STRUCTURAL CONCRETE.
Location Description: MONTEREY COUNTY NEAR LITTLE SUR RIVER FROM 0.4 MILE SOUTH OF LITTLE SUR RIVER BRIDGE TO 0.2 MILE SOUTH OF LITTLE SUR RIVER BRIDGE
Contractor Name: GORDON N BALL INC
Contractor Address: 333 CAMILLE AVENUE, ALAMO CA 94507
Resident Engineer: Arashdeep (Art) Pannu Structure Rep.: David Galarza
DIME Sample ID: 2022-02-11-9
TL Number from the TL Form: 255901
Sample Submitted By Organization: CT D05 - Prunedale Field Laboratory
Sample Organization Contact:
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 02/11/2022
Date that the sample was received by the laboratory/organization performing the testing: 02/13/2022
The quantity of what the sample constitutes: 11 CY
A brief description of the sample: 3- 4x8" Cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 0211221330
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Las Animas, Marina CA
The concrete mix design number: M779PR50S
The truck number from where the sample was collected: 113
The batch plant ticket number from where the sample was collected: NA
Concrete batch plant: Las Animas Concrete
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Concrete sample from wheelbarrow
Where the material sample would have been placed if not sampled: Station 11 plus 94 decimal 50
From Lot No.:
Bag Lot No.:
DIME Test ID: 2022-02-11-9-1
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Submitted By Organization: CT D05 - Prunedale Field Laboratory
Organization Address: 8115 Prunedale North Road,
Organization City: Salinas
Organization State: CA
Organization Zipcode: 93907
Organization Email: anthony.romiza@dot.ca.gov
Organization Phone: (805) 319-0941
Data has not been verified.
