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Sample Record for 2015-06-18-7

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

Project Information

Project ID: 210012 DEA: 080M2004 EFIS: 0800000467 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-371-67.7/72.9
Work Description: CONSTRUCT SHOULDER/RETAINING WALL ON BOTH DIRECTIONS OF ROUTE 371
Location Description: RIVERSIDE COUNTY NEAR ANZA AND CAHUILLA FROM EAST OF CARY ROAD TO EAST OF KIRBY ROAD
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 585 BEACH STREET , WATSONVILLE CA 95076
Resident Engineer: Max Quach Structure Rep.: Arnel Vega

Sample Information

DIME Sample ID: 2015-06-18-7
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: 06/18/2015
Date that the sample was received by the laboratory/organization performing the testing: 06/22/2015
The quantity of what the sample constitutes: 2
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 911-01
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: Collected at jobsite

Material Information

The concrete mix design number: D9385P
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: NOT PROVIDED
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: HEADWALL DRAINAGE SYSTEM 3 AND 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
2015-06-18-7-1CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders06/23/201507/16/2015Matthew ClaytonCT - Southern Regional Laboratory28 DAY