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Sample Record for 2022-03-10-12

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

Project Information

Project ID: 214819 DEA: 07288304 EFIS: 0700021024 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-60,60,164,210-Var
Work Description: STORM WATER MITIGATION
Location Description: LOS ANGELES COUNTY AT VARIOUS LOCATIONS
Contractor Name: CHUMO CONSTRUCTION INC
Contractor Address: 14425 Joanbridge St, Baldwin Park, CA 91706
Resident Engineer: Sushilkumar Chaudhari Structure Rep.: Pratheep Piratheepan

Sample Information

DIME Sample ID: 2022-03-10-12
TL Number from the TL Form: 1036-310
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 03/10/2022
Date that the sample was received by the laboratory/organization performing the testing: 03/11/2022
The quantity of what the sample constitutes: 6
A brief description of the sample: Concrete Cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 1036-310
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Robertsons

Material Information

The concrete mix design number: SC270N31
The truck number from where the sample was collected: NA
The batch plant ticket number from where the sample was collected: NA
Concrete batch plant: ROBERTSONS
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Rte 210 E. End of Placement Next to Roadway load 1
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2022-03-10-12-1
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.