DIME - Test Summary

Summary for Test 2018-02-23-10-4

Test performed: CTM 556-January 2018

Project Identifiers	Project ID: 211260 DEA: 072159U4 EFIS: 0715000160
DIST-CO-RTE-PM	07-LA,ORA-5-0.0/1.5, 44.3/44.4
Award Date	05/27/2016
Closeout Date	08/01/2023
Work Description	CONSTRUCT HOV LANES AND MIX FLOW LANES.
Location Description	LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
QA Service Level	1 (Verified on 03/16/2016)

Sample Taken Date	02/23/2018	Sample Unique Key	10
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	02/24/2018
Sample type	Quality Control	A brief description of the sample	6x12 Cylinders
The quantity of what the sample constitutes	6	From where was the sample collected	Job Site
First name of sampler or witnessed by	Ryan	Last name of sampler or witnessed by	DeVaul
Title of sampler	QC Field Technician	Telephone number of sampler	Unknown
Laboratory sample identification	Set 2	Linked DIME Sample ID	Unknown
The fabricator/manufacturer/facility name	Jobsite	Transportation Laboratory (TL) Number	Unknown
Inspector Lot Number from the Transportation Laboratory (TL) Form	Unknown	Structure unique identifier	Unknown
Structure name	Unknown

Material Type	Concrete	The concrete mix design number	S62578
The truck number from where the sample was collected	Load 11	The batch plant ticket number from where the sample was collected	212888
Concrete batch plant	Unknown	The fabricator/manufacturer designation for the sample	Set 2
A detailed description of where the material sample was collected	RW 52 Footing	Where the material sample would have been placed if not sampled	Unknown
From Lot No.	Unknown	Bag Lot No.	Unknown

DIME Sample ID: 2018-02-23-10

DIME Test ID: 2018-02-23-10-4

Testing Lab: G3 Quality, Incorporated - Cerritos

Test Method: CTM 556-January 2018: Method of Test for Slump of Fresh Portland Cement Concrete

Test Release Date: 2018-11-06

Input Type: Calculated

Tester's full name: Ryan DeVaul

Date of test: 02/23/2018

Slump: 5.75 inch

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

Test was verified on 11/6/2018 ✔