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Sample Record for 2015-05-26-3

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: 905 E 3rd St, Corona, CA 92879
Resident Engineer: Salim Khalil Structure Rep.: Alex Angha

Sample Information

DIME Sample ID: 2015-05-26-3
TL Number from the TL Form: SRL 55
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 05/26/2015
Date that the sample was received by the laboratory/organization performing the testing: 05/28/2015
The quantity of what the sample constitutes: 6
A brief description of the sample: 6X12
From where was the sample collected: Job Site
Laboratory sample identification: 888-SRL55
Structure unique identifier: BR 23 BENT 2
Structure name: 91 CIP
The fabricator/manufacturer/facility name: JOB

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: 118025279
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: LOAD 3
Where the material sample would have been placed if not sampled: Unknown
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 2

DIME Test ID: 2015-05-26-3-1
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 06/02/2015
Date Tested: 06/02/2015
Submitted By Organization: CT - Southern Regional Laboratory
Organization Address: 13970 Victoria St,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 213-792-4794
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) 4010 psi
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Age of specimen 7 days

Test 2 of 2

DIME Test ID: 2015-05-26-3-2
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 06/09/2015
Date Tested: 06/09/2015
Submitted By Organization: CT - Southern Regional Laboratory
Organization Address: 13970 Victoria St,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 213-792-4794
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) 4800 psi
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Age of specimen 14 days

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
2015-05-26-3-3CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders05/28/201506/23/2015Matthew ClaytonCT - Southern Regional Laboratory28 DAY