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Testing Report for 2015-09-23-8-1

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

Project Information

DEA: 04235624
EFIS: 0400000678
Project ID: 209187
QA Service Level: 1
DIST-CO-RTE-PM: 04-SCL,SM-101-52.0/52.6,0.0/0.6
Work Description: BRIDGE REPLACEMENT
Location Description: SANTA CLARA AND SAN MATEO COUNTIES IN PALO ALTO AND EAST PALO ALTO FROM OREGON EXPRESSWAY OVERCROSSING TO 0.3 MILE SOUTH OF UNIVERSITY AVENUE OVERCROSSING
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Fernando Abela
Structure Rep.: Yannaing Tun

Sample Information

DIME Sample ID: 2015-09-23-8
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT SC Sub-unit 3674-104
Sample Organization Contact:
Type of Sample: Verification
Type of Material: Concrete
Sample Taken Date: 9/23/2015
Date that the sample was received by the laboratory/organization performing the testing: 9/28/2015
The quantity of what the sample constitutes: 4 6x12 concrete cylinders
A brief description of the sample: 4 6x12 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification: Unknown
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: Central Plant

Material Information

The concrete mix design number: D101C5E1
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: 18094380
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: truck chute
Where the material sample would have been placed if not sampled: Unknown
From Lot No.:
Bag Lot No.:

Test Information

DIME Test ID: 2015-09-23-8-1
Test Method: ASTM C143-15a: Standard Test Method for Slump of Hydraulic-Cement Concrete
Date Tested: 9/23/2015
Verified Date: 9/30/2015
Submitted By Organization: CT SC Sub-unit 3674-104
Organization Address: ,
Organization City:
Organization State:
Organization Zipcode:
Organization Email:
Organization Phone:
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified :

Submitted Test Results

Slump: 3.75 inch