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Sample Record for 2015-05-04-5

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

Project Information

Project ID: 209240 DEA: 07259204 EFIS: 0700020196 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-10-R8.8/13.5
Work Description: CONSTRUCT AUSTIN VAULT SAND FILTER BEDS.
Location Description: LOS ANGELES COUNTY IN LOS ANGELES FROM LA CIENEGA BOULEVARD TO 0.3 MILE WEST OF VERMONT AVENUE
Contractor Name: BALTAZAR CONSTRUCTION INC
Contractor Address: 236 E ARROW HWY, COVINA, CA 91722
Resident Engineer: SAYKALI ZARIF Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2015-05-04-5
TL Number from the TL Form: 150504
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: 05/04/2015
Date that the sample was received by the laboratory/organization performing the testing: 05/06/2015
The quantity of what the sample constitutes: 6
A brief description of the sample: 6x12
From where was the sample collected: Job Site
Laboratory sample identification: 903-04
Structure unique identifier: AVSF
Structure name: AVSF FOOTING AT LOCATION 10
The fabricator/manufacturer/facility name: JOB

Material Information

The concrete mix design number: 556300
The truck number from where the sample was collected: 464
The batch plant ticket number from where the sample was collected: 658
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: CHUTE
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: 2015-05-04-5-1
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 05/11/2015
Date Tested: 05/11/2015
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) 2980 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: 2015-05-04-5-2
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 05/18/2015
Date Tested: 05/18/2015
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) 3940 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: 2015-05-04-5-3
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 06/01/2015
Date Tested: 06/01/2015
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) 4520 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