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Sample Record for 2015-06-15-1

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

Project Information

Project ID: 209681 DEA: 080J9304 EFIS: 0800020192 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-147.6
Work Description: BRIDGE REHABILITATION
Location Description: SAN BERNARDINO COUNTY NEAR BAKER AT HALLORAN WASH BRIDGE.
Contractor Name: AUTOBAHN CONSTRUCTION
Contractor Address: 933 N Batavia St, , Orange, CA 92867
Resident Engineer: John F Santos Structure Rep.: Ahmad Ankir

Sample Information

DIME Sample ID: 2015-06-15-1
TL Number from the TL Form: 081418
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: 06/15/2015
Date that the sample was received by the laboratory/organization performing the testing: 06/17/2015
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: 904-18
Structure unique identifier: HALLORAN WASH BRIDGE
Structure name: SOUTH BOND FRONT COLUMNS ENCASEMENT
The fabricator/manufacturer/facility name: JOB

Material Information

The concrete mix design number: SM450P47
The truck number from where the sample was collected: 1
The batch plant ticket number from where the sample was collected: 1
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: WHEEL BARROW
Where the material sample would have been placed if not sampled: Unknown
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 2

DIME Test ID: 2015-06-15-1-1
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 06/18/2015
Date Tested: 06/18/2015
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 28.37 in^2
Cross sectional area of cylinder 2 28.37 in^2
Compressive strength (to nearest 10 psi) 3000 psi
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Age of specimen 3 days

Test 2 of 2

DIME Test ID: 2015-06-15-1-2
Test Method: CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 06/22/2015
Date Tested: 06/22/2015
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 28.46 in^2
Cross sectional area of cylinder 2 28.46 in^2
Compressive strength (to nearest 10 psi) 3640 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