DIME - Test Summary

Summary for Test 2020-12-04-14-3

Test performed: CTM 504-June 2010

Project Identifiers	Project ID: 213707 DEA: 081C38U4 EFIS: 0817000196
DIST-CO-RTE-PM	08-RIV-10-6.7/R25.1
Award Date	11/26/2019
Closeout Date	11/01/2023
Work Description	Remove concrete pavement and base, and place HMA and JPCP
Location Description	ROUTE 10/60 SEPARATION IN BEAUMONT TO ROUTE 10/111 SEPARATION NEAR CABAZON.
QA Service Level	1 (Verified on 01/09/2020)

Sample Taken Date	12/04/2020	Sample Unique Key	14
Will the laboratory/organization for which you are a member perform testing on this material sample?	Yes	Date that the sample was received by the laboratory/organization performing the testing	12/05/2020
Sample type	Quality Assurance	A brief description of the sample	JPCP beams
The quantity of what the sample constitutes	4 Beams	From where was the sample collected	Job Site
First name of sampler or witnessed by	Alexsey, Kennedy	Last name of sampler or witnessed by	Souglobov, Eubany
Title of sampler		Telephone number of sampler
Laboratory sample identification	36JA1, 36JA2, 36JB1, 36JB2	Linked DIME Sample ID
The fabricator/manufacturer/facility name	Coffman Specialties, Inc	Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name

Material Type	Concrete	The concrete mix design number	1906-2
The truck number from where the sample was collected	Unknown	The batch plant ticket number from where the sample was collected	tt
Concrete batch plant	Unknown	The fabricator/manufacturer designation for the sample	Unknown
A detailed description of where the material sample was collected	Discharge from concrete truck into wheelbarrow	Where the material sample would have been placed if not sampled	Unknown
From Lot No.	Unknown	Bag Lot No.	Unknown

DIME Sample ID: 2020-12-04-14

DIME Test ID: 2020-12-04-14-3

Testing Lab: CT D08 - Fontana Field Testing Laboratory

Test Method: CTM 504-June 2010: Method of Test for Determining Air Content of Freshly Mixed Concrete by the Pressure Method

Test Release Date: 2020-12-29

Input Type: Calculated

Tester's full name: A. Souglobov

Date of test: 12/14/2020

Air Content: 4.6 %

General comments (publicly viewable) (Max 1000 characters):

Test was verified on 12/29/2020 ✔