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Sample Record for 2015-04-07-2

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

Project Information

Project ID: 208862 DEA: 080K7104 EFIS: 0800000366 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15,215-14.0/R16.4,16.0/17.8
Work Description: I-15/I-215 Interchange Improvements (Devore)
Location Description: On I-15 from 0.8 mile south of Glen Helen Parkway UC to 1.4 mile north of Kenwood Ave UC And On I-215 from 1.2 mile south of Devore Road OC to the I-15 junction
Contractor Name: Atkinson Construction,, LLC
Contractor Address: 1672 Devore Road, San Bernardino, CA 92407
Resident Engineer: Owen Spencer Structure Rep.: Scott Gueltzow

Sample Information

DIME Sample ID: 2015-04-07-2
TL Number from the TL Form: 20150705
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: 04/07/2015
Date that the sample was received by the laboratory/organization performing the testing: 04/09/2015
The quantity of what the sample constitutes: 4
A brief description of the sample: Concrete 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: site

Material Information

The concrete mix design number: ct1c4500di
The truck number from where the sample was collected: 47
The batch plant ticket number from where the sample was collected: np
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: bridge 24 deck
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: 2015-04-07-2-1
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 05/05/2015
Date Tested: 05/05/2015
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Cross sectional area of cylinder 1 28.27 in^2
Cross sectional area of cylinder 2 28.37 in^2
Compressive strength (to nearest 10 psi) 5570 psi
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Age of specimen 28 days

Test 2 of 2

DIME Test ID: 2015-04-07-2-2
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 05/19/2015
Date Tested: 05/19/2015
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Cross sectional area of cylinder 1 28.27 in^2
Cross sectional area of cylinder 2 28.27 in^2
Compressive strength (to nearest 10 psi) 5880 psi
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Age of specimen 42 days