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Testing Report for 2014-01-10-15501642-3

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

Project Information

DEA: 080N5904
EFIS: 0800000533
Project ID: 8127
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-40-R85.2
Work Description: CONSTRUCT PC/PS BULB-TEE GIRDER BRIDGE
Location Description: SAN BERNARDINO COUNTY NEAR ESSEX AT VAN WINKLE WASH BRIDGE
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Khoa Nguyen
Structure Rep.: Ching Chuang

Sample Information

DIME Sample ID: 2014-01-10-15501642
TL Number from the TL Form:
Sample Submitted By Organization: SCST, LLC.
Sample Organization Contact: (619) 280-4321
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 1/10/2014
Date that the sample was received by the laboratory/organization performing the testing: 1/10/2014
The quantity of what the sample constitutes: 5 cylinders
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: High Grade

Material Information

The concrete mix design number: HG53401R
The truck number from where the sample was collected: 172
The batch plant ticket number from where the sample was collected: 307695
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Concrete Truck 172
Where the material sample would have been placed if not sampled: Bent 1 South Column and Two Piles at Northeast Side
From Lot No.:
Bag Lot No.:

Test Information

DIME Test ID: 2014-01-10-15501642-3
Test Method: ASTM C1064-08: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Date Tested: 1/10/2014
Verified Date: 2/10/2014
Submitted By Organization: SCST, LLC.
Organization Address: 6280 Riverdale Street,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92120
Organization Email: dhicks@scst.com
Organization Phone: (619) 280-4321
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Temperature: 61 F