Sample Record for 2015-04-30-3
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: 2015-04-30-3
TL Number from the TL Form: 180598
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Verification
Type of Material: Concrete
Sample Taken Date: 04/30/2015
Date that the sample was received by the laboratory/organization performing the testing: 05/04/2015
The quantity of what the sample constitutes: 2
A brief description of the sample: 6X12
From where was the sample collected: Job Site
Laboratory sample identification: 868-98
Structure unique identifier: RETAINING WALL 7
Structure name: STEM WALL STATION 11 10 to 12 02
The fabricator/manufacturer/facility name: JOB
Material Information
The concrete mix design number: CM5800
The truck number from where the sample was collected: 191
The batch plant ticket number from where the sample was collected: 103033741
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: CHUTE
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: 2015-04-30-3-1
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 06/11/2015
Date Tested: 06/11/2015
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: (909) 829-3029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Cross sectional area of cylinder 1
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28.09 in^2
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Cross sectional area of cylinder 2
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28.09 in^2
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Compressive strength (to nearest 10 psi)
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4060 psi
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Comment on any defect in either specimen or caps (Max 250 Characters)
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no data
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Correction factor for cylinder 1
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1
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Age of specimen
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42 days
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