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Sample Record for 2022-10-14-55

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

Project Information

Project ID: 993484 DEA: 07325904 EFIS: 0716000091 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-87.4
Work Description: SEISMIC RETROFIT OF BRIDGE, WIDEN
Location Description: IN LOS ANGELES COUNTY, NEAR KERN COUNTY LINE, AT THE TEJON PASS OVERCROSSING BRIDGE NO 53-1779
Contractor Name: POWELL CONSTRUCTORS INC
Contractor Address: 8555 BANANA AVE, FONTANA, CA 92335
Resident Engineer: Oscar Osorio Structure Rep.: Adriana Pimienta

Sample Information

DIME Sample ID: 2022-10-14-55
TL Number from the TL Form:
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 10/14/2022
Date that the sample was received by the laboratory/organization performing the testing: 10/24/2022
The quantity of what the sample constitutes: 1 day
A brief description of the sample: PCC cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 22-0329
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Robertsons - Palmdale

Material Information

The concrete mix design number: CT800F254AS
The truck number from where the sample was collected: 1
The batch plant ticket number from where the sample was collected: NA
Concrete batch plant: Robertsons Palmdale
The fabricator/manufacturer designation for the sample: Robertsons Ready Mix
A detailed description of where the material sample was collected: CHUTE FROM TRUCK
Where the material sample would have been placed if not sampled: Paving Slope
From Lot No.:
Bag Lot No.:
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2022-10-14-55-1
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 817-0387
Data has not been verified.