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Testing Report for 2015-05-12-1-1

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

Project Information

DEA: 034F0704
EFIS: 0314000020
Project ID: 209788
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-50-17.1
Work Description: WIDEN STRUCTURE, EXTEND WEAVE LANE, AND ADD RAMP METERING.
Location Description: SACRAMENTO COUNTY AT NATOMA OVERHEAD
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Joseph Estepa
Structure Rep.: Brandon Miller

Sample Information

DIME Sample ID: 2015-05-12-1
TL Number from the TL Form: 173232
Sample Submitted By Organization: CT SC Sub-unit 3665-103
Sample Organization Contact:
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 5/12/2015
Date that the sample was received by the laboratory/organization performing the testing: 5/13/2015
The quantity of what the sample constitutes: 6 concrete cylinders
A brief description of the sample: 6 6x12 Concrete Cylinders
From where was the sample collected: Job Site
Laboratory sample identification: Unknown
Structure unique identifier: 24 0120
Structure name: Natoma OH
The fabricator/manufacturer/facility name: Jobsite

Material Information

The concrete mix design number: F628AFST0
The truck number from where the sample was collected: 56
The batch plant ticket number from where the sample was collected: 1061340
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: Pump hopper into wheelbarrow
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Information

DIME Test ID: 2015-05-12-1-1
Test Method: CTM 533-June 2010: Method of Test for Ball Penetration in Fresh Portland Cement Concrete
Date Tested: 5/12/2015
Verified Date: 5/13/2015
Submitted By Organization: CT SC Sub-unit 3665-103
Organization Address: ,
Organization City:
Organization State:
Organization Zipcode:
Organization Email:
Organization Phone:
General Comments for this Test:
Test Result Compliance: comply
Additional Comments When Verified :

Submitted Test Results

No reportable test results have been submitted for this test.