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Sample Record for 2015-07-07-3

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

Project Information

Project ID: 209139 DEA: 071170U4 EFIS: 0700000085 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-10-33.2/37.2
Work Description: CONSTRUCT HOV LANES, WIDEN BRIDGES, AND REALIGN RAMPS.
Location Description: LOS ANGELES COUNTY IN BALDWIN PARK AND WEST COVINA FROM 0.1 MILE WEST OF PUENTE AVENUE UNDERCROSSING TO 0.2 MILE EAST OF HOLLENBECK STREET UNDERCROSSING
Contractor Name: Ames Construction, inc.
Contractor Address: 391 N Main Street, Suite 302, Corona, Ca 92880
Resident Engineer: Raj Punjabi Structure Rep.: Cardiel Bugarin

Sample Information

DIME Sample ID: 2015-07-07-3
TL Number from the TL Form: 1756120F
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 07/07/2015
Date that the sample was received by the laboratory/organization performing the testing: 07/10/2015
The quantity of what the sample constitutes: 4
A brief description of the sample: Concrete Cylinder 6 x 12
From where was the sample collected: Job Site
Laboratory sample identification: 882-20F
Structure unique identifier: Unknown
Structure name: RW 1822
The fabricator/manufacturer/facility name: Holliday Rock Upland

Material Information

The concrete mix design number: CM5645
The truck number from where the sample was collected: 603
The batch plant ticket number from where the sample was collected: 101053066
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Plant
A detailed description of where the material sample was collected: Truck
Where the material sample would have been placed if not sampled: RW 1822 Sta1822 Plus 20 to 1828 Plus 95
From Lot No.:
Bag Lot No.:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2015-07-07-3-1
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 07/14/2015
Date Tested: 07/14/2015
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:
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) 3130 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: 2015-07-07-3-2
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 08/12/2015
Date Tested: 08/04/2015
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:
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) 4250 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