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Sample Record for 2015-09-10-2


Project Information

Project ID: 209187 DEA: 04235624 EFIS: 0400000678 COOP: 042583 QA Service Level: 1
DIST-CO-RTE-PM: 04-SCL,SM-101-52.0/52.6,0.0/0.6
Work Description: BRIDGE REPLACEMENT
Location Description: SANTA CLARA AND SAN MATEO COUNTIES IN PALO ALTO AND EAST PALO ALTO FROM OREGON EXPRESSWAY OVERCROSSING TO 0.3 MILE SOUTH OF UNIVERSITY AVENUE OVERCROSSING
Contractor Name: GHILOTTI BROS / RM HARRIS JV Contractor Address: 525 JACOBY STREET
Resident Engineer: Fernando Abela Structure Rep.: Tun, Yannaing

Sample Information

DIME Sample ID: 2015-09-10-2
TL Number from the TL Form:
Sample Submitted By Organization: CT SC Sub-unit 3674-104
Sample Organization Contact:
Type of Sample: Verification
Type of Material: Concrete
Sample Taken Date: 09/10/2015
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 4
A brief description of the sample: 4 6x12 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name: San Francisquito Creek Bridge

Material Information

The concrete mix design number: D15PP562
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 18086523
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: truck chute
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 1

DIME Test ID: 2015-09-10-2-1
Test Method: ASTM C143-15a: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 09/30/2015
Date Tested: 09/10/2015
Submitted By Organization: CT SC Sub-unit 3674-104
Organization Address:
Test General Comments:
Additional Comments When Verified:
Slump 4 inch