Sample Record for 2022-03-17-72
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214469 DEA: 030H08U4 EFIS: 0319000029
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-50-L0.2/R6.1
Work Description: Sac 50 Design Build PLEASE NOTE THAT DESIGN BUILDER MUST PERFORM QUALITY VALIDATION TESTING IN ACCORDANCE WITH THE MATERIAL CONTROL SCHEDULE (MCS) FOR ITEMS SUCH AS STRANDS, HS BOLTS, ELASTOMERIC BEARING PADS, JOINT SEALANTS, COUPLERS & WELDED HOOPS, ETC
Location Description: FROM 0.1 MILE EAST OF I-5 TO 0.8 MILE EAST OF WATT AVE
Contractor Name: FLATIRON WEST INC
Contractor Address: 2100 Goodyear Rd., Benicia, CA 94510
Resident Engineer: Jim Rogers Structure Rep.: Daniel Eggers
Sample Information
DIME Sample ID: 2022-03-17-72
TL Number from the TL Form: Unknown
Sample Submitted By Organization: G3 Quality, Incorporated - Cerritos
Sample Organization Contact: (562) 321-9840
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 03/17/2022
Date that the sample was received by the laboratory/organization performing the testing: 03/18/2022
The quantity of what the sample constitutes: 2
A brief description of the sample: 4x8 concrete cylinders
From where was the sample collected: Source
Laboratory sample identification: RDCS-245
Structure unique identifier: 00-0000
Structure name: Unknown
The fabricator/manufacturer/facility name: Elite Ready Mix
Material Information
The concrete mix design number: CT600
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 0
Concrete batch plant: Elite Ready Mix
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Unknown
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test Results
Test 1 of 2
DIME Test ID: 2022-03-17-72-1
Test Method: AASHTO T336-15: Standard Method of Test for Coefficient of Thermal Expansion of Hydraulic Cement Concrete
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
Data has not been verified.
Test 2 of 2
DIME Test ID: 2022-03-17-72-2
Test Method: AASHTO T336-15: Standard Method of Test for Coefficient of Thermal Expansion of Hydraulic Cement Concrete
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
Data has not been verified.
