Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214573 DEA: 073096U4 EFIS: 0719000091
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-210-R0.0/R9.7
Work Description: PLACE CONCRETE PAVEMENT, BARRIER, HMA, DRAINAGE, AND ELECTRICAL.
Location Description: LOS ANGELES COUNTY IN LOS ANGELES FROM INTERSTATE 5 TO WHEATLAND AVENUE UNDERCROSSING
Contractor Name: FLATIRON WEST INC
Contractor Address: 15335 FAIRFIELD RANCH ROAD, CHINO HILLS, CA 91709
Resident Engineer: Ridwan Salman Structure Rep.: Adriana Pimienta
DIME Sample ID: 2022-02-16-6
TL Number from the TL Form:
Sample Submitted By Organization: Kleinfelder, Incorporated - Los Angeles
Sample Organization Contact: (909) 833-5780
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 02/16/2022
Date that the sample was received by the laboratory/organization performing the testing: 02/17/2022
The quantity of what the sample constitutes: 62 CY
A brief description of the sample: A set of 2 LCB cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 22-0319
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Flatiron Plant - Paxton off-Ramp
The concrete mix design number: LCB-3215-03
The truck number from where the sample was collected: Load 1
The batch plant ticket number from where the sample was collected: 58282732
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Concrete from wheelbarrow
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2022-02-16-6-1
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Verified Date: 02/23/2022
Date Tested: 02/23/2022
Submitted By Organization: Kleinfelder, Incorporated - Los Angeles
Organization Address: 620 South Magnolia Avenue, Building G,
Organization City: Ontario
Organization State: CA
Organization Zipcode: 91762
Organization Email: mdorsch@kleinfelder.com
Organization Phone: (909) 833-5780
General Comments for this Test: EB 210; Yarnell On-ramp, MVP 2.
Test Result Compliance:
Additional Comments When Verified:
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Unit system used?
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US Units
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Number of specimens
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2
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Test performed
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With no density determined
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Capped in accordance with?
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no data
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Apparent mass of submerged cylinder 1
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0 lb
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Average diameter of cylinder 1
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6.00 in
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Average diameter of cylinder 2
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6.00 in
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Cross sectional area of cylinder 1
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0 in^2
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Cross sectional area of cylinder 2
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0 in^2
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Compressive strength (to nearest 10 psi)
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0 psi
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Maximum load on cylinder 1
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21240 lb
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Maximum load on cylinder 2
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22120 lb
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Type of fracture pattern of cylinder 1
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5
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Type of fracture pattern of cylinder 2
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5
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Comment on any defect in either specimen or caps (Max 250 Characters)
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no data
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Correction factor for cylinder 1
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1.00
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Correction factor for cylinder 2
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1.00
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Age of specimen
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0 days
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Age of specimen in hours
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0 hours
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Serial number of delivery ticket, if available
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no data
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