Sample Record for 2015-03-21-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 209217 DEA: 080F5404 EFIS: 0800000136 COOP: 081468
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-91,15-0.0/13.04, 35.64/45.14
Work Description: SR-91 Corridor Improvement Project: Develop approx. 8 miles of tolled express lanes and related improvements within SR 91 between the Riverside/Orange County line and I-15, including transition areas.
Location Description: 08-RIV-91-0.0/13.04; 12-ORA-91-R14.43/R18.91; 08-RIV-15-35.64/45.14
Contractor Name: Atkinson Walsh, Joint Venture
Contractor Address: 1785 Sampson Ave, Corona, CA 92879
Resident Engineer: Richard Hebert Structure Rep.: Cyrus Shahinpar
Sample Information
DIME Sample ID: 2015-03-21-2
TL Number from the TL Form: SRL30
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: 03/21/2015
Date that the sample was received by the laboratory/organization performing the testing: 03/24/2015
The quantity of what the sample constitutes: 6
A brief description of the sample: concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 888SRL30
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: Holliday Rock Chino
Material Information
The concrete mix design number: CM5634
The truck number from where the sample was collected: 297
The batch plant ticket number from where the sample was collected: 118021164
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: 91CIP
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 |
| 2015-03-21-2-1 | CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders | 03/24/2015 | 04/04/2015 | Friday Ofoegbu | CT D08 - Fontana Southern Regional Laboratory | 14 days | |
| 2015-03-21-2-2 | CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders | 03/24/2015 | 04/11/2015 | Friday Ofoegbu | CT D08 - Fontana Southern Regional Laboratory | 21 days | |
| 2015-03-21-2-3 | CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders | 03/24/2015 | 04/18/2015 | Friday Ofoegbu | CT D08 - Fontana Southern Regional Laboratory | 28 days | |
147114721473
