Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994102 DEA: 11430644 EFIS: 1119000045
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-905-12.0
Work Description: CONSTRUCT WEIGH-IN-MOTION FACILITY, CRCP, HMA, AND RETAINING WALL.
Location Description: SAN DIEGO COUNTY NEAR SAN DIEGO AT OTAY MESA COMMERCIAL VEHICLE ENFORCEMENT FACILITY
Contractor Name: SEMA Construction
Contractor Address: 42690 Rio Nedo Suite G, Temecula, CA 92590
Resident Engineer: Daniela Gomez Structure Rep.: Unknown
DIME Sample ID: 2023-04-06-62
TL Number from the TL Form:
Sample Submitted By Organization: CT D11 - South County/Trade Corridor FO
Sample Organization Contact: 6197607875
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 04/06/2023
Date that the sample was received by the laboratory/organization performing the testing: 04/10/2023
The quantity of what the sample constitutes: 40 CY
A brief description of the sample: Structural Concrete
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name: Retaining Wall
The fabricator/manufacturer/facility name: Robertson's Otay Mesa
The concrete mix design number: RRM20038
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 230387
Concrete batch plant: Otay Mesa Plant
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Concrete sample from wheelbarrow
Where the material sample would have been placed if not sampled: Retaining Wall Footing
From Lot No.:
Bag Lot No.:
DIME Test ID: 2023-04-06-62-1
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Submitted By Organization: CT D11 - South County/Trade Corridor FO
Organization Address: 5377 Otay Mesa Road, MS 334 / SCTC (TCIF),
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92154
Organization Email: carlos.covarrubias@dot.ca.gov
Organization Phone: (619) 760-7875
Data has not been verified.
