Sample Record for 2023-08-04-64
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 215753 DEA: 050N72U4 EFIS: 0520000169
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-4.4/R7.7
Work Description: Please cc Office Engineer Ni Nyoman Paul on reports sent to RE and SR. Construct High Occupancy Vehicle (HOV) lanes on U.S. Route 101 and rehabilitation - Segment 4B.
Location Description: 101 freeway in Summerland, CA
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 5335 Debbie Road, Santa Barbara, CA 93111
Resident Engineer: Luobao Cai Structure Rep.: Emiliano Berntsen
Sample Information
DIME Sample ID: 2023-08-04-64
TL Number from the TL Form:
Sample Submitted By Organization: CT D05 - Carpinteria Field Laboratory
Sample Organization Contact: (805) 621-3616
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 08/04/2023
Date that the sample was received by the laboratory/organization performing the testing: 08/04/2023
The quantity of what the sample constitutes: 110CY
A brief description of the sample: PCC
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CEMEX Santa Barbara
Material Information
The concrete mix design number: 1614705
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 30867178
Concrete batch plant: Cemex Santa Barbara
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Back of truck discharge chute in wheelbarrow
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test Results
Test 1 of 3
DIME Test ID: 2023-08-04-64-1
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Verified Date: 08/14/2023
Date Tested: 08/04/2023
Submitted By Organization: CT D05 - Carpinteria Field Laboratory
Organization Address: 21 Griffin Road North,
Organization City: Windsor
Organization State: CT
Organization Zipcode: 06095-1590
Organization Email: dlachaine@trccompanies.com
Organization Phone: (805) 621-3616
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Test 2 of 3
DIME Test ID: 2023-08-04-64-2
Test Method: ASTM C143-10a: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 08/14/2023
Date Tested: 08/04/2023
Submitted By Organization: CT D05 - Carpinteria Field Laboratory
Organization Address: 21 Griffin Road North,
Organization City: Windsor
Organization State: CT
Organization Zipcode: 06095-1590
Organization Email: dlachaine@trccompanies.com
Organization Phone: (805) 621-3616
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Test 3 of 3
DIME Test ID: 2023-08-04-64-3
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Submitted By Organization: CT D05 - Carpinteria Field Laboratory
Organization Address: 21 Griffin Road North,
Organization City: Windsor
Organization State: CT
Organization Zipcode: 06095-1590
Organization Email: dlachaine@trccompanies.com
Organization Phone: (805) 621-3616
Data has not been verified.