Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214135 DEA: 09213404 EFIS: 0900000030
QA Service Level: 1
DIST-CO-RTE-PM: 09-INY-395-29.9/41.8
Work Description: ROADWAY EXCAVATION, PLACE HMA (TYPE A), AND ALTERNATIVE PIPE CULVERT.
Location Description: INYO COUNTY NEAR OLANCHA AND CARTAGO FROM 1.4 MILES SOUTH OF LOS ANGELES AQUEDUCT BRIDGE TO 0.2 MILE SOUTH OF ASH CREEK BRIDGE
Contractor Name: FISHER SAND & GRAVEL CO.
Contractor Address: 1302 W DRIVERS WAY, TEPE, AZ. 85284
Resident Engineer: Kris Raber Structure Rep.: Alex Naime-Falcon
DIME Sample ID: 2023-01-06-34
TL Number from the TL Form: 09
Sample Submitted By Organization: CT D09 - Bishop Field Laboratory
Sample Organization Contact: (760) 872-5211
Type of Sample: Acceptance
Type of Material: Concrete
Sample Taken Date: 01/06/2023
Date that the sample was received by the laboratory/organization performing the testing: 01/13/2023
The quantity of what the sample constitutes: 15 CY
A brief description of the sample: PCC cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 2897
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: 7/11 Materials, Ridgecrest
The concrete mix design number: 01-01-2023
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 9999
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Sample taken from the chute
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2023-01-06-34-1
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 02/13/2023
Date Tested: 02/03/2023
Submitted By Organization: CT D09 - Bishop Field Laboratory
Organization Address: 500 South Main Street,
Organization City: Bishop
Organization State: CA
Organization Zipcode: 93514
Organization Email: chris.talbot@dot.ca.gov
Organization Phone: (760) 872-0794
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
|
Number of specimens
|
3
|
|
Average Compressive Strength (to nearest 10)
|
4770 lb/in^2
|
|
Cylinder Age
|
28 days
|
|
Break Description of Cylinder 1 (if not 'cone')
|
no data
|
|
Break Description of Cylinder 2 (if not 'cone')
|
no data
|
|
Break Description of Cylinder 3 (if not 'cone')
|
no data
|
