Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215039 DEA: 081H4004 EFIS: 0817000031
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-40-0.4
Work Description: MINOR CONCRETE (MINOR STRUCTURE).
Location Description: SAN BERNARDINO COUNTY IN BARSTOW AT 0.4 MILE EAST OF ROUTE 15
Contractor Name: Pacific Restoration Group Inc
Contractor Address: PO Box 2061, Lake Elsinore, CA 92531-2061
Resident Engineer: Thanh Pham Structure Rep.: Husam Mohd Ankir
DIME Sample ID: 2021-01-22-5
TL Number from the TL Form: 1024-122
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 01/22/2021
Date that the sample was received by the laboratory/organization performing the testing: 01/29/2021
The quantity of what the sample constitutes: 2 cylinders
A brief description of the sample: concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 1024-122
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Robertsons
The concrete mix design number: SC505B38
The truck number from where the sample was collected: NA
The batch plant ticket number from where the sample was collected: NA
Concrete batch plant: ROBERTSONS
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: DRUM TRUCK
Where the material sample would have been placed if not sampled: STA 1525 I40 BLAIR DITCH CHANNEL
From Lot No.:
Bag Lot No.:
DIME Test ID: 2021-01-22-5-1
Test Method: ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Verified Date: 02/09/2021
Date Tested: 02/01/2021
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Unit system used?
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US Units
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Number of specimens
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2
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Test performed
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With no density determined
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Capped in accordance with?
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ASTM C617/CTM521
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Average diameter of cylinder 1
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6.00 in
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Average diameter of cylinder 2
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6.00 in
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Cross sectional area of cylinder 1
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28.27 in^2
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Cross sectional area of cylinder 2
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28.27 in^2
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Compressive strength (to nearest 10 psi)
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2220 psi
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Maximum load on cylinder 1
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62380 lb
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Maximum load on cylinder 2
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62890 lb
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Compressive strength of cylinder 1
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2206.6 psi
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Type of fracture pattern of cylinder 1
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5
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Compressive strength of cylinder 2
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2224.6 psi
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Type of fracture pattern of cylinder 2
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5
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Comment on any defect in either specimen or caps (Max 250 Characters)
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no data
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Correction factor for cylinder 1
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1
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Correction factor for cylinder 2
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1
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Age of specimen
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10 days
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Age of specimen in hours
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no data
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