Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 209698 DEA: 072332E4 EFIS: 0700000391 COOP: 0705187
QA Service Level: 2
DIST-CO-RTE-PM: 07-LA-I-5-45.4/54
Work Description: Addition of 14 miles of HOV lanes in both directions would extend existing carpool lanes on the I- 5 in San Fernando Valley to Santa Clarita Valley
Location Description: The I-5 North Capacity Enhancements Project focuses on improvements to the I-5 freeway from cities of Santa Clarita and Castaic, beginning at the SR-14 interchange to Parker Rd.
Contractor Name: Not yet Awarded
Contractor Address: Unknown
Resident Engineer: Emile Eid Structure Rep.: Chanh Tong
DIME Sample ID: 2022-09-28-42
TL Number from the TL Form:
Sample Submitted By Organization: Sequoia Consultants
Sample Organization Contact: (714) 974-6316
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 09/28/2022
Date that the sample was received by the laboratory/organization performing the testing: 09/29/2022
The quantity of what the sample constitutes: 2 cylinders
A brief description of the sample: structural concrete
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: National Ready Mix
The concrete mix design number: S63C451T1
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 271411
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: RW2622
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2022-09-28-42-1
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 12/14/2022
Date Tested: 10/26/2022
Submitted By Organization: Sequoia Consultants
Organization Address: 361 West Grove Avenue,
Organization City: Orange
Organization State: CA
Organization Zipcode: 92865
Organization Email: sranjan@sequoiacon.com
Organization Phone: 1 (714) 974-6316
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Number of specimens
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2
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Average Compressive Strength (to nearest 10)
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4230 lb/in^2
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Cylinder Age
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28 days
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Break Description of Cylinder 1 (if not 'cone')
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3
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Break Description of Cylinder 2 (if not 'cone')
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3
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