Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212112 DEA: 080C2514 EFIS: 0816000076 COOP: 081645
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-10-0.0/13.2
Work Description: Design-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes
Location Description: LA/SBD County Line to PM 13.2 near I-15
Contractor Name: Lane-Security Paving Joint Venture
Contractor Address: 3450 Centre Lake Drive, 1st Floor, Ontario, CA 91761
Resident Engineer: Jose Corona Structure Rep.: Luis Negrete
DIME Sample ID: 2022-05-31-2
TL Number from the TL Form:
Sample Submitted By Organization: Con-Fab California Corporation - Lathrop
Sample Organization Contact: (209) 249-4700
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 05/31/2022
Date that the sample was received by the laboratory/organization performing the testing: 05/31/2022
The quantity of what the sample constitutes: 1 cubic ft. of Concrete for Testing
A brief description of the sample: 1 cubic ft. of Concrete taken from middle of batching
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Con-Fab California, LLC
The concrete mix design number: VER-98LV
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 5018
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Bed 1B, 3rd Truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2022-05-31-2-1
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 06/01/2022
Date Tested: 05/31/2022
Submitted By Organization: Con-Fab California Corporation - Lathrop
Organization Address: 1910 Lathrop Road,
Organization City: Lathrop
Organization State: CA
Organization Zipcode: 95330
Organization Email: dannyc@confabca.com
Organization Phone: (209) 249-4717
General Comments for this Test: Flow: 21.5"
VSI: 0
Test Result Compliance:
Additional Comments When Verified:
DIME Test ID: 2022-05-31-2-2
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Verified Date: 06/01/2022
Date Tested: 05/31/2022
Submitted By Organization: Con-Fab California Corporation - Lathrop
Organization Address: 1910 Lathrop Road,
Organization City: Lathrop
Organization State: CA
Organization Zipcode: 95330
Organization Email: dannyc@confabca.com
Organization Phone: (209) 249-4717
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
DIME Test ID: 2022-05-31-2-3
Test Method: ASTM C138-17a: Standard Test Method for Density (Unit Weight), Yield, and Air Content (Gravimetric) of Concrete
Verified Date: 06/01/2022
Date Tested: 05/31/2022
Submitted By Organization: Con-Fab California Corporation - Lathrop
Organization Address: 1910 Lathrop Road,
Organization City: Lathrop
Organization State: CA
Organization Zipcode: 95330
Organization Email: dannyc@confabca.com
Organization Phone: (209) 249-4717
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Identification of concrete represented by the sample
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1B, 3rd Truck
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Volume of the measure
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0.25 ft^3
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Density of concrete
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150 lb/ft^3
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Yield of concrete
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no data
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Relative yield of the batch
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no data
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Cement content
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no data
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Air content
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no data
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DIME Test ID: 2022-05-31-2-4
Test Method: ASTM C231-17a: Standard Test Method for Air Content of Freshly Mixed Concrete by the Pressure Method
Verified Date: 06/01/2022
Date Tested: 05/31/2022
Submitted By Organization: Con-Fab California Corporation - Lathrop
Organization Address: 1910 Lathrop Road,
Organization City: Lathrop
Organization State: CA
Organization Zipcode: 95330
Organization Email: dannyc@confabca.com
Organization Phone: (209) 249-4717
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
DIME Test ID: 2022-05-31-2-5
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Verified Date: 06/01/2022
Date Tested: 06/01/2022
Submitted By Organization: Con-Fab California Corporation - Lathrop
Organization Address: 1910 Lathrop Road,
Organization City: Lathrop
Organization State: CA
Organization Zipcode: 95330
Organization Email: dannyc@confabca.com
Organization Phone: (209) 249-4717
General Comments for this Test:
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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Apparent mass of submerged cylinder 1
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29.12 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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28.27 in^2
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Cross sectional area of cylinder 2
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28.27 in^2
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Compressive strength (to nearest 10 psi)
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6840 psi
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Maximum load on cylinder 1
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190000 lb
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Maximum load on cylinder 2
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196500 lb
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Type of fracture pattern of cylinder 1
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2
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Type of fracture pattern of cylinder 2
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2
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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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1 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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