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Sample Record for 2015-06-01-2

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

Project Information

Project ID: 209553 DEA: 08336304 EFIS: 0800000608 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-38-26.3/26.8
Work Description: BRIDGE DECK REPLACEMENT
Location Description: SAN BERNARDINO COUNTY NEAR BARTON FLATS AT HATHAWAY CREEK BRIDGE
Contractor Name: POWELL CONSTRUCTORS, INC.
Contractor Address: 8555 Banana Ave, Fontana, CA 92335
Resident Engineer: Nhan Nguyen Structure Rep.: Tim Flores

Sample Information

DIME Sample ID: 2015-06-01-2
TL Number from the TL Form: 1
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: 06/01/2015
Date that the sample was received by the laboratory/organization performing the testing: 06/03/2015
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: 906-1
Structure unique identifier: RT 36 PM 26 6 GLASS ROAD AND RT 38
Structure name: Unknown
The fabricator/manufacturer/facility name: job

Material Information

The concrete mix design number: HG78547A
The truck number from where the sample was collected: 158
The batch plant ticket number from where the sample was collected: 293213
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: NP
Where the material sample would have been placed if not sampled: Unknown
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 3

DIME Test ID: 2015-06-01-2-1
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 06/08/2015
Date Tested: 06/08/2015
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 28.09 in^2
Cross sectional area of cylinder 2 28.09 in^2
Compressive strength (to nearest 10 psi) 4920 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 3

DIME Test ID: 2015-06-01-2-2
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 06/15/2015
Date Tested: 06/15/2015
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 28.18 in^2
Cross sectional area of cylinder 2 28.18 in^2
Compressive strength (to nearest 10 psi) 5620 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

Test 3 of 3

DIME Test ID: 2015-06-01-2-3
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 06/29/2015
Date Tested: 06/29/2015
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 28.18 in^2
Cross sectional area of cylinder 2 28.18 in^2
Compressive strength (to nearest 10 psi) 6490 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

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.