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Sample Record for 2015-04-06-1

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 208869 DEA: 08368504 EFIS: 0800000628 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-177.3/181.1
Work Description: CONSTRUCT COMMERCIAL VEHICLE ENFORCEMENT FACILITY (CVEF)
Location Description: SAN BERNARDINO COUNTY FROM 1.2 MILES NORTH OF NIPTON ROAD OVERCROSSING TO 0.5 MILE SOUTH OF YATES WELL ROAD OVERCROSSING
Contractor Name: Las Vegas Paving Corporation
Contractor Address: 4420 S Decatur Blvd, Las Vegas, NV 89103
Resident Engineer: John Santos Structure Rep.: Lawrence Monsalud

Sample Information

DIME Sample ID: 2015-04-06-1
TL Number from the TL Form: 20150406
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 04/06/2015
Date that the sample was received by the laboratory/organization performing the testing: 04/08/2015
The quantity of what the sample constitutes: 6
A brief description of the sample: Concrete Cylinders
From where was the sample collected: Job Site
Laboratory sample identification: Unknown
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: Site

Material Information

The concrete mix design number: P40AF883
The truck number from where the sample was collected: 1 and 3
The batch plant ticket number from where the sample was collected: site
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: CVEF CIDH Foundation for high mast light and communication foundation
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 3

DIME Test ID: 2015-04-06-1-1
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 04/20/2015
Date Tested: 04/13/2015
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:
Cross sectional area of cylinder 1 28.37 in^2
Cross sectional area of cylinder 2 28.37 in^2
Compressive strength (to nearest 10 psi) 3520 psi
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Age of specimen 7 days

Test 2 of 3

DIME Test ID: 2015-04-06-1-2
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 04/20/2015
Date Tested: 04/20/2015
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:
Cross sectional area of cylinder 1 28.37 in^2
Cross sectional area of cylinder 2 28.37 in^2
Compressive strength (to nearest 10 psi) 6020 psi
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Age of specimen 14 days

Test 3 of 3

DIME Test ID: 2015-04-06-1-3
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 05/04/2015
Date Tested: 05/04/2015
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:
Cross sectional area of cylinder 1 28.27 in^2
Cross sectional area of cylinder 2 28.27 in^2
Compressive strength (to nearest 10 psi) 5550 psi
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Age of specimen 28 days