Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993493 DEA: 100Q1224 EFIS: 1014000168
QA Service Level: 1
DIST-CO-RTE-PM: 10-MER-99-28.2/R37.3
Work Description: WIDEN CONCRETE PAVEMENT LANES AND BRIDGES.
Location Description: MERCED COUNTY IN AND NEAR LIVINGSTON FROM 0.8 MILE SOUTH OF HAMMATT AVENUE OVERCROSSING TO STANISLAUS COUNTY LINE
Contractor Name: SECURITY PAVING COMPANY, INC. - Bassel Jamaleddine
Contractor Address: 3075 Townsgate Rd. Suite 200, Westlake Village CA 91361
Resident Engineer: Tofael Anwar Structure Rep.: Karen Sampson
DIME Sample ID: 2022-12-09-53
TL Number from the TL Form:
Sample Submitted By Organization: CT D10 - Turlock Structures Construction Field Office
Sample Organization Contact: (209) 815-3666
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 12/09/2022
Date that the sample was received by the laboratory/organization performing the testing: 12/13/2022
The quantity of what the sample constitutes: 26 CY
A brief description of the sample: 4x8 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name: COLLIER ROAD UC
The fabricator/manufacturer/facility name: Buliders Concrete
The concrete mix design number: ND10531
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 510145538
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Abutment no 2
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2022-12-09-53-1
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Submitted By Organization: CT D10 - Turlock Structures Construction Field Office
Organization Address: 3240 North Millbrook Avenue,
Organization City: Fresno
Organization State: CA
Organization Zipcode: 93726
Organization Email: kelvin.low@dot.ca.gov
Organization Phone: (209) 815-3666
Data has not been verified.
DIME Test ID: 2022-12-09-53-2
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Submitted By Organization: CT D10 - Turlock Structures Construction Field Office
Organization Address: 3240 North Millbrook Avenue,
Organization City: Fresno
Organization State: CA
Organization Zipcode: 93726
Organization Email: kelvin.low@dot.ca.gov
Organization Phone: (209) 815-3666
Data has not been verified.
DIME Test ID: 2022-12-09-53-3
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Submitted By Organization: CT D10 - Turlock Structures Construction Field Office
Organization Address: 3240 North Millbrook Avenue,
Organization City: Fresno
Organization State: CA
Organization Zipcode: 93726
Organization Email: kelvin.low@dot.ca.gov
Organization Phone: (209) 815-3666
Data has not been verified.
