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Sample Record for 2015-03-30-2

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

Project Information

Project ID: 209809 DEA: 041G6504 EFIS: 0400020538 COOP: 042316 QA Service Level: 1
DIST-CO-RTE-PM: 04-SF-101-5.0/6.0
Work Description: Install new pedestrian tunnel connecting a future hospital and medical office building
Location Description: Beneath and across a portion of Rte 101 in the City and County of SF at Van Ness Ave
Contractor Name: HerreroBoldt
Contractor Address: 1200 Van Ness Avenue , San Francisco, CA 94109
Resident Engineer: Dan brodnik Structure Rep.: Sergio Gomez

Sample Information

DIME Sample ID: 2015-03-30-2
TL Number from the TL Form: 192460
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Informational
Type of Material: Concrete
Sample Taken Date: 03/30/2015
Date that the sample was received by the laboratory/organization performing the testing: 04/01/2015
The quantity of what the sample constitutes: 2
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Source
Laboratory sample identification: Unknown
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: KieCon

Material Information

The concrete mix design number: K254265
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: 0
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: solid slab
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 1

DIME Test ID: 2015-03-30-2-1
Test Method: ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Capped in accordance with ASTM C617/CTM521
Submitted By Organization: CT HQ - QASI Bay Area Field Office
Organization Address: 690 Walnut Avenue, Suite 150,
Organization City: Vallejo
Organization State: CA
Organization Zipcode: 94592
Organization Email: maged.g.armanuse@dot.ca.gov
Organization Phone: (916) 284-6784
Data has not been verified.