DIME - Test Summary

Summary for Test 2018-10-30-11-5

Test performed: CTM 504-June 2010

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	10/30/2018	Sample Unique Key	11
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	11/01/2018
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	Martin	Last name of sampler or witnessed by	Serna
Title of sampler	QC Field Technician	Telephone number of sampler	Unknown
Laboratory sample identification	Set 1	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	G3-15-STR-002
The truck number from where the sample was collected	Load 2	The batch plant ticket number from where the sample was collected	0
Concrete batch plant	Unknown	The fabricator/manufacturer designation for the sample	Set 1
A detailed description of where the material sample was collected	Pier 3 invert	Where the material sample would have been placed if not sampled	Unknown
From Lot No.	Unknown	Bag Lot No.	Unknown

DIME Sample ID: 2018-10-30-11

DIME Test ID: 2018-10-30-11-5

Testing Lab: G3 Quality, Incorporated - Cerritos

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

Test Release Date: 2019-02-21

Input Type: Calculated

Tester's full name: Martin Serna

Date of test: 10/30/2018

Air Content: 1.2 %

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

Test was verified on 2/21/2019 ✔