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Compression Test Report: Sampling Information

This compression test report summarizes the testing of concrete samples from a school district project. It provides information on the project location, sample details like mix numbers and curing methods, and testing details such as sample identification, dates tested, and compression strengths. The results showed that the tested material met the specified strength requirements and was sampled and tested according to the approved documents.

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Luqman Shamsudin
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75 views2 pages

Compression Test Report: Sampling Information

This compression test report summarizes the testing of concrete samples from a school district project. It provides information on the project location, sample details like mix numbers and curing methods, and testing details such as sample identification, dates tested, and compression strengths. The results showed that the tested material met the specified strength requirements and was sampled and tested according to the approved documents.

Uploaded by

Luqman Shamsudin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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FORM

DSA-204
Rev. 05/11

COMPRESSION TEST REPORT


School District:

LEA #: _________________DSA FILE #:

Attn:
Address:

Exp. Date: ______________DSA APPL #:


Lab Facility:
CA

Lab Doc #: ________________ Lab Job #:

Project Name:

Structure:

Location in Structure:_______________________

Report Date:

Sampled By: _____________________________

Sample Date:

SAMPLING INFORMATION
Material:

Specified Strength ___________psi @ _______ days

Concrete Grout Mortar Prisms Cores Other


Actual

Spec.

Pass/
Fail?

Mix Number:

Load #:___________________

Slump (inches)

Concrete Supplier: __________________________________

Percent Air (%)

Truck #: _____________ Ticket #:


____________________

Unit Weight (pcf)

Time Batched:

Air Temperature (F)

Set #:______ of

Mix Temperature (F)

Sampled from:

TESTING INFORMATION

Time Sampled:
yds

of

Chute Hose Other _

Date Samples Received

___

total yds

Curing Method

Identification
Date Tested
Age in Days
Diameter/Size (in.)
Correction Factor
Cross Sect. Area (in.2)
Maximum Load (lbs.)
Compr. Strength (psi)
Fracture Type

Concrete: Average of 2 (28 day) tests:


Mortar, Grout, Shotcrete: Average of 3 (28 day) tests:

Applicable ASTM Test Methods:


Tested by:

REMARKS:

The Material

WAS

WAS NOT

SAMPLED AND TESTED IN ACCORDANCE WITH


THE REQUIREMENTS OF THE DSA APPROVED DOCUMENTS.
Structural Engineer
Project
Inspector
cc:
Project
Architect
DSA Regional Office

psi
psi

ADDITIONAL COMMENTS (DSA-211) ATTACHED.

The Material Tested

MET

DID NOT MEET

THE REQUIREMENTS OF THE DSA APPROVED DOCUMENTS.

Signature

Date

Print Name / Title

FORM DSA-204 (rev 05/17/11)


Compression Test Report

PAGE 2 OF 1
CALIFORNIA DEPARTMENT OF GENERAL SERVICES

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