Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 209503 DEA: 11257154 EFIS: 1100020489
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-76,15-R46.2/R46.8, R12.1/R17.7
Work Description: CONSTRUCT 4 LANE HIGHWAY.
Location Description: SAN DIEGO COUNTY NEAR BONSALL AND FALLBROOK ON ROUTE 15 FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF ROUTE 76/15 SEPARATION AND ON ROUTE 76 FROM 0.4 MILE WEST OF SOUTH MISSION ROAD TO 0.5 MILE EAST OF ROUTE 76/15 SEPARATION
Contractor Name: Ames Construction
Contractor Address: 2000 AMES DRIVE , BURNSVILLE, MN 55306
Resident Engineer: Gary Levine Structure Rep.: Phong Le
DIME Sample ID: 2015-07-21-2
TL Number from the TL Form: L79 CSIP 001
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 07/21/2015
Date that the sample was received by the laboratory/organization performing the testing: 07/23/2015
The quantity of what the sample constitutes: 2
A brief description of the sample: 6X12
From where was the sample collected: Job Site
Laboratory sample identification: 913-01
Structure unique identifier: CONSTRUCT 4 LANE HWY
Structure name: CASTING BED 9 GIRDER G1 8
The fabricator/manufacturer/facility name: JOB
The concrete mix design number: 1457-1
The truck number from where the sample was collected: LOAD 7
The batch plant ticket number from where the sample was collected: 56933
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: TUCKER DISCHARGE
Where the material sample would have been placed if not sampled: Unknown
From Lot No.:
Bag Lot No.:
DIME Test ID: 2015-07-21-2-1
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 07/28/2015
Date Tested: 07/28/2015
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
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28.37 in^2
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Cross sectional area of cylinder 2
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28.37 in^2
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Compressive strength (to nearest 10 psi)
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9490 psi
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Comment on any defect in either specimen or caps (Max 250 Characters)
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no data
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Correction factor for cylinder 1
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1
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Age of specimen
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7 days
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