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Sample Record for 2019-10-16-16

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

Project Information

Project ID: 211260 DEA: 072159U4 EFIS: 0715000160 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: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 TOWNSGATE RD. SUITE 200, WESTLAKE VILLAGE, CA 91361
Resident Engineer: George Saker Structure Rep.: Danny Lalonde

Sample Information

DIME Sample ID: 2019-10-16-16
TL Number from the TL Form: Unknown
Sample Submitted By Organization: G3 Quality, Incorporated - Cerritos
Sample Organization Contact: (562) 321-9840
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 10/16/2019
Date that the sample was received by the laboratory/organization performing the testing: 10/17/2019
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: 00-0000
Structure name: Unknown
The fabricator/manufacturer/facility name: Jobsite

Material Information

The concrete mix design number: S70356
The truck number from where the sample was collected: Load 3
The batch plant ticket number from where the sample was collected: 0
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Set 1
A detailed description of where the material sample was collected: Coyote Creek Wash RTE 5 Valley View
Where the material sample would have been placed if not sampled: Unknown
From Lot No.: Unknown
Bag Lot No.: Unknown

Test Results

Test 1 of 5

DIME Test ID: 2019-10-16-16-1
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 11/18/2019
Date Tested: 10/23/2019
Submitted By Organization: G3 Quality, Incorporated - 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: 562-321-9853
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens 2
Average Compressive Strength (to nearest 10) 4530 lb/in^2
Cylinder Age 7 days
Break Description of Cylinder 1 (if not 'cone') no data
Break Description of Cylinder 2 (if not 'cone') no data

Test 2 of 5

DIME Test ID: 2019-10-16-16-2
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 11/18/2019
Date Tested: 11/13/2019
Submitted By Organization: G3 Quality, Incorporated - 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: 562-321-9853
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens 2
Average Compressive Strength (to nearest 10) 5580 lb/in^2
Cylinder Age 28 days
Break Description of Cylinder 1 (if not 'cone') no data
Break Description of Cylinder 2 (if not 'cone') no data

Test 3 of 5

DIME Test ID: 2019-10-16-16-3
Test Method: ASTM C1064-12: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Verified Date: 11/18/2019
Date Tested: 10/16/2019
Submitted By Organization: G3 Quality, Incorporated - 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: 562-321-9853
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Temperature 87 F

Test 4 of 5

DIME Test ID: 2019-10-16-16-4
Test Method: ASTM C138-17a: Standard Test Method for Density (Unit Weight), Yield, and Air Content (Gravimetric) of Concrete
Verified Date: 11/18/2019
Date Tested: 10/16/2019
Submitted By Organization: G3 Quality, Incorporated - 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: 562-321-9853
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Identification of concrete represented by the sample 0
Volume of the measure 0 ft^3
Density of concrete 149.2 lb/ft^3
Yield of concrete no data
Relative yield of the batch no data
Cement content no data
Air content no data

Test 5 of 5

DIME Test ID: 2019-10-16-16-5
Test Method: ASTM C231-17a: Standard Test Method for Air Content of Freshly Mixed Concrete by the Pressure Method
Verified Date: 11/18/2019
Date Tested: 10/16/2019
Submitted By Organization: G3 Quality, Incorporated - 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: 562-321-9853
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Air content 2.2 %