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Sample Record for 2022-07-05-5

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

Project Information

Project ID: 99999 DEA: 0322222 QA Service Level:
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Michael Maksimovich Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2022-07-05-5
TL Number from the TL Form:
Sample Submitted By Organization: ZZCT DIME Development Laboratory A - Bellflower - Internal
Sample Organization Contact: (213) 555-1212
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 07/05/2022
Date that the sample was received by the laboratory/organization performing the testing: 07/05/2022
The quantity of what the sample constitutes: 8 Cylinders
A brief description of the sample: type ii concrete
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Reinforced Earth Co

Material Information

The concrete mix design number: CT675F25
The truck number from where the sample was collected: 223
The batch plant ticket number from where the sample was collected: 660383
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: ORO GRANDE
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: 2022-07-05-5-1
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 07/17/2023
Date Tested: 07/06/2023
Submitted By Organization: ZZCT DIME Development Laboratory A - Bellflower - Internal
Organization Address: 1234 Norwalk Boulevard,
Organization City: Bellflower
Organization State: CA
Organization Zipcode: 90725
Organization Email: test.user@dot.ca.gov
Organization Phone: (213) 555-1212
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Slump 5 inch

Test 2 of 2

DIME Test ID: 2022-07-05-5-2
Test Method: ASTM C231-17a: Standard Test Method for Air Content of Freshly Mixed Concrete by the Pressure Method
Verified Date: 07/08/2022
Date Tested: 07/08/2022
Submitted By Organization: ZZCT DIME Development Laboratory A - Bellflower - Internal
Organization Address: 1234 Norwalk Boulevard,
Organization City: Bellflower
Organization State: CA
Organization Zipcode: 90725
Organization Email: test.user@dot.ca.gov
Organization Phone: (213) 555-1212
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Air content 5.1 %