Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 10016 DEA: 06342524 EFIS: 0600000381
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-180-R71.8/74.5
Work Description: NEW EXPRESS HIGHWAY
Location Description: FRESNO COUNTY ABOUT 6.3 MILES EAST OF FRESNO FROM 0.6 MILE WEST OF QUALITY AVENUE TO 0.2 MILE WEST OF SMITH AVENUE
Contractor Name: American Paving Co
Contractor Address: 315 North Thorne Avenue, Fresno, CA 93706
Resident Engineer: Mark Mengoni Structure Rep.: Mike Bloom
DIME Sample ID: 2013-10-22-7054
TL Number from the TL Form:
Sample Submitted By Organization: CT D06 - Fresno Field Laboratory
Sample Organization Contact: (559) 230-3109
Type of Sample: Verification
Type of Material: Concrete
Sample Taken Date: 10/22/2013
Date that the sample was received by the laboratory/organization performing the testing: 10/24/2013
The quantity of what the sample constitutes: 2 cylinders
A brief description of the sample: Concrete cylinders
From where was the sample collected: Other
Laboratory sample identification: CL132177
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Field
The concrete mix design number: Unknown
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: Unknown
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Back of truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2013-10-22-7054-1
Test Method: ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Capped in accordance with ASTM C617/CTM521
Verified Date: 03/19/2015
Date Tested: 01/03/2014
Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
General Comments for this Test:
Test Result Compliance: comply
Additional Comments When Verified:
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Unit system used?
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US Units
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Number of specimens
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2
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Test performed
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no data
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Comment on any defect in either specimen or caps (Max 250 Characters)
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no data
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