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Sample Record for 2015-04-24-4

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

Project Information

Project ID: 5266 DEA: 08448404 EFIS: 0800000712 COOP: 081488A1 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-91-15.6/21.6
Work Description: CONSTRUCT HOV LANES AND WIDEN BRIDGES.
Location Description: RIVERSIDE COUNTY IN RIVERSIDE FROM ADAMS STREET TO THE ROUTE 60/215 SEPARATION
Contractor Name: SEMA CONSTRUCTION INC
Contractor Address: 320 Goddard, Suite 150, , Irvine, CA 92618
Resident Engineer: Joseph Lopez Structure Rep.: Al-Hakem Alina

Sample Information

DIME Sample ID: 2015-04-24-4
TL Number from the TL Form: 015429
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Verification
Type of Material: Concrete
Sample Taken Date: 04/24/2015
Date that the sample was received by the laboratory/organization performing the testing: 04/30/2015
The quantity of what the sample constitutes: 4
A brief description of the sample: 6x12
From where was the sample collected: Job Site
Laboratory sample identification: 825-29
Structure unique identifier: SR 91 MADISON AVE to UNIVERSITY AVE IN RIV
Structure name: PRESSURE MANHOLE AT UNIVERSITY EB OFF RAMP DS 107E
The fabricator/manufacturer/facility name: JOB

Material Information

The concrete mix design number: SM446B39
The truck number from where the sample was collected: 1
The batch plant ticket number from where the sample was collected: 9989088
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: FORM
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2015-04-24-4-1
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 05/01/2015
Date Tested: 05/01/2015
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) 5480 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 2

DIME Test ID: 2015-04-24-4-2
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 05/08/2015
Date Tested: 05/08/2015
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) 6050 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