DIME - Test Summary

Summary for Test 2022-12-09-43-1

Test performed: CTM 557-June 2020

Project Identifiers	Project ID: 215129 DEA: 050N73U4 EFIS: 0520000166
DIST-CO-RTE-PM	05-SB-101-7.3/9.6
Award Date	10/22/2020
Closeout Date	12/11/2023
Work Description	!!Please CC Office Engineer Gabrielle Herrera on reports to RE and SR!! Segment 4C - Summerland: Construct HOV lanes and rehabilitation. Source inspection of sign structure trusses, lighting structures, steel soldier piles, epoxy coated rebar,
Location Description	SUMMERLAND FROM 0.2 MILES NORTH OF PARDARO LANE OVERCROSSING TO SAN YSIDRO CREEK BRIDGE
QA Service Level	1 (Verified on 08/24/2020)

Sample Taken Date	12/09/2022	Sample Unique Key	43
Will the laboratory/organization for which you are a member perform testing on this material sample?	Yes	Date that the sample was received by the laboratory/organization performing the testing	12/09/2022
Sample type	Quality Assurance	A brief description of the sample	concrete
The quantity of what the sample constitutes	28.5 cy	From where was the sample collected	Job Site
First name of sampler or witnessed by	Jesse	Last name of sampler or witnessed by	Gomez
Title of sampler		Telephone number of sampler	8055501704
Laboratory sample identification		Linked DIME Sample ID
The fabricator/manufacturer/facility name	Martin Marietta Goleta	Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name

Material Type	Concrete	The concrete mix design number	72F1S0Z
The truck number from where the sample was collected	43	The batch plant ticket number from where the sample was collected	3432440
Concrete batch plant		The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collected	Discharge from concrete truck into wheelbarrow.	Where the material sample would have been placed if not sampled
From Lot No.		Bag Lot No.

DIME Sample ID: 2022-12-09-43

DIME Test ID: 2022-12-09-43-1

Testing Lab: CT D05 - Carpinteria Field Laboratory

Test Method: CTM 557-June 2020: Method of Test for Temperature of Freshly Mixed Hydraulic Cement Concrete

Test Release Date: 2023-01-23

Input Type: Measured

Tester's full name: Jesse Gomez

Date of test: 12/09/2022

Temperature: 62 F

General comments (publicly viewable) (Max 1000 characters):

Test was verified on 1/23/2023 ✔