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Sample Record for 2019-04-08-7

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

Project Information

Project ID: 209694 DEA: 080J0704 EFIS: 0800000282 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-215-0.6/1.7
Work Description: (Alternative Delivery) The CMGC project will reconstruct and improve interchange of I-215 and Barton Road in the City of Grand Terrace, CA.
Location Description: Grade separation at Intersection of I-215 and Barton Road near Grand Terrace, CA. ? On I-215 between I-10 and SR-60.
Contractor Name: Myers / Rados-Southern California Jobsite Office
Contractor Address: 12210 Michigan St., Suite D, Grand Terrace, CA 92313
Resident Engineer: Fereydoon Alipanah Structure Rep.: Tim Flores

Sample Information

DIME Sample ID: 2019-04-08-7
TL Number from the TL Form: 20190408A
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 04/08/2019
Date that the sample was received by the laboratory/organization performing the testing: 04/24/2019
The quantity of what the sample constitutes: 2
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 975-408A
Structure unique identifier: abutment 1 stage 2 footing
Structure name: abutment 1 stage 2 footing
The fabricator/manufacturer/facility name: Robertson Riverside

Material Information

The concrete mix design number: SC590B38
The truck number from where the sample was collected: 146
The batch plant ticket number from where the sample was collected: 4369261
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: MYERS
A detailed description of where the material sample was collected: 95 cy
Where the material sample would have been placed if not sampled: abutment 1 stage 2 footing
From Lot No.: Unknown
Bag Lot No.: Unknown
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2019-04-08-7-1
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 04/29/2019
Date Tested: 04/29/2019
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens 2
Average Compressive Strength (to nearest 10) 3830 lb/in^2
Cylinder Age 21 days
Break Description of Cylinder 1 (if not 'cone') 1
Break Description of Cylinder 2 (if not 'cone') 1