Sample Record for 2015-03-05-4
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 209019 DEA: 071952U4 EFIS: 0700000201
QA Service Level: 1
DIST-CO-RTE-PM: 07-VEN-23,101-3.3/3.8,R0.1/R4.5
Work Description: WIDEN FREEWAY AND RAMPS AND RECONSTRUCT MEDIAN.
Location Description: VENTURA COUNTY IN THOUSAND OAKS ON ROUTE 101 FROM 0.6 MILE SOUTH OF WESTLAKE BOULEVARD OVERCROSSING TO 0.4 MILE NORTH OF MOORPARK ROAD UNDERCROSSING AND ON ROUTE 23 FROM ROUTE 101 TO 0.1 MILE NORTH OF HILLCREST DRIVE UNDERCROSSING
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 13170 TELFAIR AVENUE, SYLMAR, CA 91342
Resident Engineer: Alfred Ira Structure Rep.: Rahim Ranjkesh
Sample Information
DIME Sample ID: 2015-03-05-4
TL Number from the TL Form: 106614
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 03/05/2015
Date that the sample was received by the laboratory/organization performing the testing: 03/09/2015
The quantity of what the sample constitutes: 6
A brief description of the sample: cylinders
From where was the sample collected: Job Site
Laboratory sample identification: Unknown
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: Unknown
Material Information
The concrete mix design number: none
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: Unknown
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: 101 33TO 38
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test Results
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| 2015-03-05-4-1 | CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders | 03/09/2015 | 03/12/2015 | Matthew Clayton | CT D08 - Fontana Southern Regional Laboratory | 7 DAY | |
| 2015-03-05-4-2 | CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders | 03/09/2015 | 03/15/2015 | Matthew Clayton | CT D08 - Fontana Southern Regional Laboratory | 10 DAY | |
| 2015-03-05-4-3 | CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders | 03/09/2015 | 04/02/2015 | Matthew Clayton | CT D08 - Fontana Southern Regional Laboratory | 28 DAY | |
136613671368
