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Testing Report for 2021-06-17-55-6

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

Project Information

DEA: 072159U4
EFIS: 0715000160
Project ID: 211260
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,ORA-5-0.0/1.5, 44.3/44.4
Work Description: CONSTRUCT HOV LANES AND MIX FLOW LANES.
Location Description: LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: George Saker
Structure Rep.: Danny Lalonde

Sample Information

DIME Sample ID: 2021-06-17-55
TL Number from the TL Form: Unknown
Sample Submitted By Organization: G3 Quality, Inc. - Cerritos
Sample Organization Contact: (562) 321-9840
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 6/17/2021
Date that the sample was received by the laboratory/organization performing the testing: 6/19/2021
The quantity of what the sample constitutes: 6
A brief description of the sample: 6x12 Cylinders
From where was the sample collected: Job Site
Laboratory sample identification: Set 1
Structure unique identifier: 00-0000
Structure name: Unknown
The fabricator/manufacturer/facility name: Jobsite

Material Information

The concrete mix design number: G3-15-3600-590
The truck number from where the sample was collected: Load 1
The batch plant ticket number from where the sample was collected: 0
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Set 1
A detailed description of where the material sample was collected: SB RTE 5 - 736 B Barrier Wall
Where the material sample would have been placed if not sampled: Unknown
From Lot No.: Unknown
Bag Lot No.: Unknown

Test Information

DIME Test ID: 2021-06-17-55-6
Test Method: CTM 556-January 2018: Method of Test for Slump of Fresh Portland Cement Concrete
Date Tested: 6/17/2021
Verified Date: 8/30/2021
Submitted By Organization: G3 Quality, Inc. - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: (562) 321-9840
General Comments for this Test: Slump value for CT556 is actually measured as 3.8 inch at the field. Due to the DIME system only accepting the Slump in value of 0.25 inch, nearest value of 3.75 was entered.
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Slump: 3.75 inch