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Sample Record for 2015-06-02-3

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: 2015-06-02-3
TL Number from the TL Form: SRL 56
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: 06/02/2015
Date that the sample was received by the laboratory/organization performing the testing: 06/02/2015
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-SRL56
Structure unique identifier: 91 CIP
Structure name: BR 25 STEM AND SOFFIT
The fabricator/manufacturer/facility name: JOB

Material Information

The concrete mix design number: 5640
The truck number from where the sample was collected: 633
The batch plant ticket number from where the sample was collected: 118025900
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: LOAD 4
Where the material sample would have been placed if not sampled: Unknown
From Lot No.:
Bag Lot No.:

Test Results

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
2015-06-02-3-1CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders06/04/201506/16/2015Matthew ClaytonCT - Southern Regional Laboratory14 DAY
2015-06-02-3-2CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders06/04/201506/23/2015Matthew ClaytonCT - Southern Regional Laboratory21 DAY
2015-06-02-3-3CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders06/04/201506/30/2015Matthew ClaytonCT - Southern Regional Laboratory28 DAY