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Testing Report for 2016-04-07-6-4

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

Project Information

DEA: 07215954
EFIS: 0700001835
Project ID: 209141
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-0.0/7.6
Work Description: WIDENING FREEWAY AND RECONSTRUCT OVERHEAD AND OVERCROSSING STRUCTURES
Location Description: LOS ANGELES COUNTY IN LA MIRADA, SANTA FE SPRINGS, NORWALK AND DOWNEY FROM ORANGE COUNTY/LOS ANGELES COUNTY LIMIT LINES TO 0.7 MILE NORTH OF ROUTE 605
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Thang Ton
Structure Rep.: Amare Tsagie

Sample Information

DIME Sample ID: 2016-04-07-6
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: 4/7/2016
Date that the sample was received by the laboratory/organization performing the testing: 4/8/2016
The quantity of what the sample constitutes: 6
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification: Set 1
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: Jobsite

Material Information

The concrete mix design number: S72019
The truck number from where the sample was collected: 435
The batch plant ticket number from where the sample was collected: 178824
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Set 1
A detailed description of where the material sample was collected: RW-313 CIDH
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: 2016-04-07-6-4
Test Method: ASTM C138-17a: Standard Test Method for Density (Unit Weight), Yield, and Air Content (Gravimetric) of Concrete
Date Tested: 4/7/2016
Verified Date: 1/23/2017
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:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Identification of concrete represented by the sample: S72019
Volume of the measure: 0.5 ft^3
Density of concrete: 146.4 lb/ft^3
Yield of concrete: no data
Relative yield of the batch: no data
Cement content: no data
Air content: no data