Sample Record for 2023-06-19-14
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994363 DEA: 09391504 EFIS: 0922000013 MINOR: 09A0893
QA Service Level: 1
DIST-CO-RTE-PM: 09-INY,MNO,MNO,MNO,MNO-395,395,6,6-R18.08, 63.55, 21.14, 27.4
Work Description: District CCTV and RWIS Replacements
Location Description: INYO AND MONO COUNTIES ON HIGHWAYS 395 AND 6
Contractor Name: Lee Wilson Electric
Contractor Address: PO Box 250, Arroyo Grande, CA 93421-0250
Resident Engineer: Christopher Talbot Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2023-06-19-14
TL Number from the TL Form:
Sample Submitted By Organization: CT D09 - Bishop Field Laboratory
Sample Organization Contact: (760) 872-5211
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 06/19/2023
Date that the sample was received by the laboratory/organization performing the testing: 06/20/2023
The quantity of what the sample constitutes: 2 yards
A brief description of the sample: 4 PCC Cylinders
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name: location 1
The fabricator/manufacturer/facility name: 711 Materials Ridgecrest
Material Information
The concrete mix design number: 628211A
The truck number from where the sample was collected: 86026
The batch plant ticket number from where the sample was collected: 835741
Concrete batch plant: 711 Materials Ridgecrest
The fabricator/manufacturer designation for the sample: concrete plant
A detailed description of where the material sample was collected: CHUTE FROM TRUCK
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test Results
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| 2023-06-19-14-1 | ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens | 06/21/2023 | 07/17/2023 | Jerid Kupelian | CT D09 - Bishop Field Laboratory | Hold the fourth cylinder for 56 day if strength is not met | |
75667
