Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 208945 DEA: 07288604 EFIS: 0700021080 COOP: 074663
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-710-6.0-9.4
Work Description: Gerald Desmond Bridge Replacement - A Design Build project. IQA samples will be selected by Port/Caltrans representatives and sent to Translab for testing.
Location Description: Port of Long Beach (District 7)
Contractor Name: Shimmick/FCC/Impregilo (SFI) JV
Contractor Address: 11 Golden Shore, Suite 330, Long Beach, CA 90802
Resident Engineer: Structure Rep.:
DIME Sample ID: 2015-05-22-5
TL Number from the TL Form: 1003 A7SPC
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: 05/22/2015
Date that the sample was received by the laboratory/organization performing the testing: 05/27/2015
The quantity of what the sample constitutes: 4
A brief description of the sample: 6X12
From where was the sample collected: Job Site
Laboratory sample identification: 866-A7S
Structure unique identifier: A7S PILE CAP
Structure name: OCEAN BLVD to SR 47 IN LB
The fabricator/manufacturer/facility name: JOB
The concrete mix design number: SFI PCV2F
The truck number from where the sample was collected: 419
The batch plant ticket number from where the sample was collected: 5144357
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: TRUCK
Where the material sample would have been placed if not sampled: Unknown
From Lot No.:
Bag Lot No.:
DIME Test ID: 2015-05-22-5-1
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 06/19/2015
Date Tested: 06/09/2015
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:
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Cross sectional area of cylinder 1
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28.27 in^2
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Cross sectional area of cylinder 2
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28.27 in^2
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Compressive strength (to nearest 10 psi)
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5700 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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18 days
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