Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994087 DEA: 051G4104 EFIS: 0515000012
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-4.0/4.8
Work Description: Santa Claus Lane Bike Path - !!Charge time to 05-0N72U4 per Project Manager / Corridor Manager!!
Location Description: !!Charge time to 05-0N72U4 per Project Manager / Corridor Manager!!
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 5335 Debbie Road, Santa Barbara, CA 93111
Resident Engineer: Luobao Cai Structure Rep.: Josh Madrigal
DIME Sample ID: 2022-12-12-20
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: 12/12/2022
Date that the sample was received by the laboratory/organization performing the testing: 12/13/2022
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: Martin Marrieta Goleta
The concrete mix design number: 725A1Z0P
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 3432464
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: SCL Bike path type 85 footing
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2022-12-12-20-1
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 01/20/2023
Date Tested: 01/09/2023
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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4390 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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no data
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Break Description of Cylinder 2 (if not 'cone')
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no data
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