Print Report | Back to Test Summary

Testing Report for 2021-07-23-30-1

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

Project Information

DEA: 041A6614
EFIS: 0415000291
Project ID: 213099
QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN-101-8.4
Work Description: CONSTRUCTION ON STATE HIGHWAY IN MARIN COUNTY IN LARKSPUR
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Steven Russell
Structure Rep.: Long Ly

Sample Information

DIME Sample ID: 2021-07-23-30
TL Number from the TL Form:
Sample Submitted By Organization: Kie-Con, Inc.
Sample Organization Contact: (925) 331-7122
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 7/23/2021
Date that the sample was received by the laboratory/organization performing the testing: 7/24/2021
The quantity of what the sample constitutes: 21 CY
A brief description of the sample: 6 x 12 Concrete Cylinders
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: KIE-CON, INC

Material Information

The concrete mix design number: K5670-500 CP R2
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 111257
Concrete batch plant:
The fabricator/manufacturer designation for the sample: 20-088A 7/23/2021
A detailed description of where the material sample was collected: Concrete sample from wheelbarrow
Where the material sample would have been placed if not sampled: I Girder
From Lot No.:
Bag Lot No.:

Test Information

DIME Test ID: 2021-07-23-30-1
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Date Tested: 7/23/2021
Verified Date: 9/14/2021
Submitted By Organization: Kie-Con, Inc.
Organization Address: 3550 Wilbur Ave,
Organization City: Antioch
Organization State: CA
Organization Zipcode: 94509
Organization Email: estuardo.ramirez@kiecon.com
Organization Phone: (925) 331-7122
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Slump: 9.75 inch