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Testing Report for 2021-10-06-7-4

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

Project Information

DEA: 050N72U4
EFIS: 0520000169
Project ID: 215753
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-4.4/R7.7
Work Description: Construct High Occupancy Vehicle (HOV) lanes on U.S. Route 101 and rehabilitation - Segment 4B.
Location Description: 101 freeway in Summerland, CA
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Taylor Merlo
Structure Rep.: Emiliano Berntsen

Sample Information

DIME Sample ID: 2021-10-06-7
TL Number from the TL Form:
Sample Submitted By Organization: Con-Fab California, LLC
Sample Organization Contact: 661-630-7162
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 10/6/2021
Date that the sample was received by the laboratory/organization performing the testing: 10/7/2021
The quantity of what the sample constitutes: Girder
A brief description of the sample: PCC 6''x12'' test cylinder
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Con-Fab California LLC

Material Information

The concrete mix design number: SCCS950F
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 1796
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Casting Bed 1 East
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Information

DIME Test ID: 2021-10-06-7-4
Test Method: ASTM C138-17a: Standard Test Method for Density (Unit Weight), Yield, and Air Content (Gravimetric) of Concrete
Date Tested: 10/6/2021
Verified Date: 10/11/2021
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Ave,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: 661-630-7162
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Identification of concrete represented by the sample: Girder
Volume of the measure: 0.25 ft^3
Density of concrete: 152.7 lb/ft^3
Yield of concrete: no data
Relative yield of the batch: no data
Cement content: no data
Air content: 1.1 %