Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 209698 DEA: 072332E4 EFIS: 0700000391 COOP: 0705187
QA Service Level: 2
DIST-CO-RTE-PM: 07-LA-I-5-45.4/54
Work Description: Addition of 14 miles of HOV lanes in both directions would extend existing carpool lanes on the I- 5 in San Fernando Valley to Santa Clarita Valley
Location Description: The I-5 North Capacity Enhancements Project focuses on improvements to the I-5 freeway from cities of Santa Clarita and Castaic, beginning at the SR-14 interchange to Parker Rd.
Contractor Name: Not yet Awarded
Contractor Address: Unknown
Resident Engineer: Emile Eid Structure Rep.: Chanh Tong
DIME Sample ID: 2023-09-13-109
TL Number from the TL Form:
Sample Submitted By Organization: Con-Fab California, LLC
Sample Organization Contact: (661) 630-7162
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 09/13/2023
Date that the sample was received by the laboratory/organization performing the testing: 09/14/2023
The quantity of what the sample constitutes: 11
A brief description of the sample: T-II/V Cement
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: ConFab California, LLC Shafter
The concrete mix design number: SCC-S8.5-0FG
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 3747
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Sampled from wheelbarrow collected from chute of ready mix truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2023-09-13-109-1
Test Method: ASTM C138-17a: Standard Test Method for Density (Unit Weight), Yield, and Air Content (Gravimetric) of Concrete
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Avenue,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: (661) 630-3281
Data has not been verified.
DIME Test ID: 2023-09-13-109-2
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Avenue,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: (661) 630-3281
Data has not been verified.
DIME Test ID: 2023-09-13-109-3
Test Method: ASTM C1611-21: Standard Test Method for Slump Flow of Self-Consolidating Concrete
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Avenue,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: (661) 630-3281
Data has not been verified.
DIME Test ID: 2023-09-13-109-4
Test Method: CTM TEMP1-16: Test Method for Monitoring Precast Concrete Curing Temperature (Curing temperature)
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Avenue,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: (661) 630-3281
Data has not been verified.
