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Sample Record for 2020-10-01-23

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

Project Information

Project ID: 211260 DEA: 072159U4 EFIS: 0715000160 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,ORA-5-0.0/1.5, 44.3/44.4
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
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 TOWNSGATE RD. SUITE 200, WESTLAKE VILLAGE, CA 91361
Resident Engineer: George Saker Structure Rep.: Danny Lalonde

Sample Information

DIME Sample ID: 2020-10-01-23
TL Number from the TL Form: Unknown
Sample Submitted By Organization: G3 Quality, Incorporated - Cerritos
Sample Organization Contact: (562) 321-9840
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 10/01/2020
Date that the sample was received by the laboratory/organization performing the testing: 10/02/2020
The quantity of what the sample constitutes: 6
A brief description of the sample: 6x12 Cylinders
From where was the sample collected: Job Site
Laboratory sample identification: Set 4
Structure unique identifier: 00-0000
Structure name: Unknown
The fabricator/manufacturer/facility name: Jobsite

Material Information

The concrete mix design number: G3-17-STR-006F
The truck number from where the sample was collected: Load 32
The batch plant ticket number from where the sample was collected: 0
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Set 4
A detailed description of where the material sample was collected: Valley View Bridge, Stage 2, Frame 3 Deck
Where the material sample would have been placed if not sampled: Unknown
From Lot No.: Unknown
Bag Lot No.: Unknown

Test Results

Test 1 of 2

DIME Test ID: 2020-10-01-23-1
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 12/17/2020
Date Tested: 10/08/2020
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens 2
Average Compressive Strength (to nearest 10) 2640 lb/in^2
Cylinder Age 6 days
Break Description of Cylinder 1 (if not 'cone') no data
Break Description of Cylinder 2 (if not 'cone') no data

Test 2 of 2

DIME Test ID: 2020-10-01-23-2
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 12/17/2020
Date Tested: 10/29/2020
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens 2
Average Compressive Strength (to nearest 10) 4520 lb/in^2
Cylinder Age 27 days
Break Description of Cylinder 1 (if not 'cone') no data
Break Description of Cylinder 2 (if not 'cone') no data