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Testing Report for 2018-02-23-9-4

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

Project Information

DEA: 072159U4
EFIS: 0715000160
Project ID: 211260
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,ORA-5-0.0/1.5, 44.3/44.4
Work Description: CONSTRUCT HOV LANES AND MIX FLOW LANES.
Location Description: LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: George Saker
Structure Rep.: Danny Lalonde

Sample Information

DIME Sample ID: 2018-02-23-9
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: 2/23/2018
Date that the sample was received by the laboratory/organization performing the testing: 2/24/2018
The quantity of what the sample constitutes: 6
A brief description of the sample: 6x12 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: S62578
The truck number from where the sample was collected: Load 3
The batch plant ticket number from where the sample was collected: 212861
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Set 1
A detailed description of where the material sample was collected: RW 52 Footing
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: 2018-02-23-9-4
Test Method: CTM 556-January 2018: Method of Test for Slump of Fresh Portland Cement Concrete
Date Tested: 2/23/2018
Verified Date: 11/6/2018
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

Slump: 5.25 inch