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Sample Record for 2014-12-31-3

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

Project Information

Project ID: 209135 DEA: 04235844 EFIS: 0400000684 COOP: 042493 QA Service Level: 1
DIST-CO-RTE-PM: 04-SM-101-16.3/17.06
Work Description: RECONSTRUCT OVERCROSSING, RETAINING WALLS, GROUND IMPROVEMENT,
Location Description: BURLINGAME
Contractor Name: GHILOTTI CONSTRUCTION COMPANY
Contractor Address: 246 GHILOTTI AVENUE, SANTA ROSA, CA 95407
Resident Engineer: Douglas Inori Structure Rep.: Jordan Jarosz

Sample Information

DIME Sample ID: 2014-12-31-3
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Informational
Type of Material: Concrete
Sample Taken Date: 12/31/2014
Date that the sample was received by the laboratory/organization performing the testing: 01/02/2015
The quantity of what the sample constitutes: Unknown
A brief description of the sample: cylinders
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier: Unknown
Structure name: Girder
The fabricator/manufacturer/facility name: KieCon

Material Information

The concrete mix design number: K6080605
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: 000
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: source
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 1

DIME Test ID: 2014-12-31-3-4
Test Method: ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Capped in accordance with ASTM C617/CTM521
Submitted By Organization: CT HQ - QASI Bay Area Field Office
Organization Address: 690 Walnut Avenue, Suite 150,
Organization City: Vallejo
Organization State: CA
Organization Zipcode: 94592
Organization Email: maged.g.armanuse@dot.ca.gov
Organization Phone: (916) 284-6784
Data has not been verified.

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
2014-12-31-3-1ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens02/18/201502/11/2015William SommerCT HQ - QASI Bay Area Field Officec1231
2014-12-31-3-2ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens02/18/201502/11/2015William SommerCT HQ - QASI Bay Area Field Officec1231
2014-12-31-3-3ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens02/18/201502/11/2015William SommerCT HQ - QASI Bay Area Field Office