Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993184 DEA: 040A7724 EFIS: 0420000288 COOP: 042763
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-80-6.4/6.8
Work Description: Excavation, HMA, structural concrete, minor concrete and drainage.
Location Description: IN BERKELEY AND ALBANY FROM 0.6 MILE NORTH OF UNIVERSITY AVENUE OVERCROSSING TO 0.3 MILE SOUTH OF EL CERRITO SEPARATION AND OVERHEAD
Contractor Name: OC Jones (Will Dieterich)
Contractor Address: 1520 Fourth Street, Berkeley, CA 94710
Resident Engineer: Maxime Dabilly Structure Rep.: Eric Urementa
DIME Sample ID: 2023-07-21-97
TL Number from the TL Form:
Sample Submitted By Organization: Golden State Bridge, Incorporated
Sample Organization Contact: (415) 720-6577
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 07/21/2023
Date that the sample was received by the laboratory/organization performing the testing: 07/21/2023
The quantity of what the sample constitutes: 5 concrete cylinders from 9 yards
A brief description of the sample: Concrete Cylinder Samples
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name: Retaining Wall #175
The fabricator/manufacturer/facility name: Central Concrete
The concrete mix design number: DDJ118E3
The truck number from where the sample was collected: 6201
The batch plant ticket number from where the sample was collected: 03919532 312
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: from the concrete truck on the site
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2023-07-21-97-1
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Verified Date: 11/09/2023
Date Tested: 07/28/2023
Submitted By Organization: Golden State Bridge, Incorporated
Organization Address: 3701 Mallard Drive ,
Organization City: Benicia
Organization State: CA
Organization Zipcode: 94510
Organization Email: paul@gsbridge.com
Organization Phone: (415) 720-6577
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
|
Unit system used?
|
US Units
|
|
Number of specimens
|
5
|
|
Test performed
|
With density determined by dimension measurements
|
|
Average cylinder density (to nearest 1 pcf)
|
0 lb/ft^3
|
|
Average diameter of cylinder 1
|
4.00 in
|
|
Average diameter of cylinder 2
|
4.00 in
|
|
Average diameter of cylinder 3
|
4.00 in
|
|
Average diameter of cylinder 4
|
4.00 in
|
|
Average diameter of cylinder 5
|
4.00 in
|
|
Comment on any defect in either specimen or caps (Max 250 Characters)
|
no data
|
|
Serial number of delivery ticket, if available
|
no data
|
