Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 8127 DEA: 080N5904 EFIS: 0800000533
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: GRANITE CONSTRUCTION COMPANY
Contractor Address: P.O. Box 50085, Watsonville, CA 95077
Resident Engineer: Khoa Nguyen Structure Rep.: Ching Chuang
DIME Sample ID: 2013-05-14-14202236
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: 05/14/2013
Date that the sample was received by the laboratory/organization performing the testing: 05/28/2013
The quantity of what the sample constitutes: Cyliners
A brief description of the sample: Concrete Test Samples
From where was the sample collected: Source
Laboratory sample identification: L70-1
Structure unique identifier: 10.5
Structure name: Bridge 2
The fabricator/manufacturer/facility name: Jobsite
The concrete mix design number: 08newe
The truck number from where the sample was collected: 1232
The batch plant ticket number from where the sample was collected: 324
Concrete batch plant: 3234
The fabricator/manufacturer designation for the sample: 234
A detailed description of where the material sample was collected: testing DIME
Where the material sample would have been placed if not sampled: Bridge Deck
From Lot No.:
Bag Lot No.:
DIME Test ID: 2013-05-14-14202236-1
Test Method: ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Capped in accordance with ASTM C617/CTM521
Verified Date: 05/28/2013
Date Tested: 05/28/2013
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: Testing
Test Result Compliance:
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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None
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