Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994503 DEA: 042W0704 EFIS: 0421000133 MINOR: 04A6556
QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN-101-
Work Description:
Location Description:
Contractor Name: CONSTRUCTION H INC
Contractor Address: 2766 Carlton Court, San Pablo, CA 94806
Resident Engineer: Dawit Habteselassie Structure Rep.: Phil Latasa
DIME Sample ID: 2024-09-28-12
TL Number from the TL Form:
Sample Submitted By Organization: CT SC - 3672 - Novato Field Office
Sample Organization Contact: (916) 621-8033
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 09/28/2024
Date that the sample was received by the laboratory/organization performing the testing: 09/28/2024
The quantity of what the sample constitutes: 20CY
A brief description of the sample: 3 4x8 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name: Overhead Sign Pile
The fabricator/manufacturer/facility name: Shamrock Materials Inc
The concrete mix design number: D67112E1
The truck number from where the sample was collected: 2422
The batch plant ticket number from where the sample was collected: 303926
Concrete batch plant: 73
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: CHUTE FROM TRUCK
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2024-09-28-12-1
Test Method: ASTM C1064-08: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Submitted By Organization: CT SC - 3672 - Novato Field Office
Organization Address: 384 Bel Marin Keys Boulevard, Suite 200,
Organization City: Novato
Organization State: CA
Organization Zipcode: 94949
Organization Email: josh.velono@dot.ca.gov
Organization Phone: (916) 621-8033
Data has not been verified.
DIME Test ID: 2024-09-28-12-2
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 10/02/2024
Date Tested: 09/28/2024
Submitted By Organization: CT SC - 3672 - Novato Field Office
Organization Address: 384 Bel Marin Keys Boulevard, Suite 200,
Organization City: Novato
Organization State: CA
Organization Zipcode: 94949
Organization Email: josh.velono@dot.ca.gov
Organization Phone: (916) 621-8033
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
DIME Test ID: 2024-09-28-12-4
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Verified Date: 11/07/2024
Date Tested: 11/06/2024
Submitted By Organization: CT HQ - Vallejo Field Laboratory
Organization Address: 690 Walnut,
Organization City: vallejo
Organization State: CA
Organization Zipcode: 94592
Organization Email: yannick.aranas@dot.ca.gov
Organization Phone: (916) 639-4315
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Unit system used?
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US Units
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Number of specimens
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3
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Test performed
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With no density determined
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Capped in accordance with?
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ASTM C1231 - Unbonded Elastomeric Pad Cap
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Apparent mass of submerged cylinder 1
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1 lb
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Average diameter of cylinder 1
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4.00 in
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Average diameter of cylinder 2
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4.00 in
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Average diameter of cylinder 3
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4.00 in
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Cross sectional area of cylinder 1
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12.57 in^2
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Cross sectional area of cylinder 2
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12.57 in^2
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Cross sectional area of cylinder 3
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12.57 in^2
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Compressive strength (to nearest 10 psi)
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6900 psi
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Maximum load on cylinder 1
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84093 lb
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Maximum load on cylinder 2
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87990 lb
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Maximum load on cylinder 3
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87990 lb
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Compressive strength of cylinder 1
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6690.0 psi
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Type of fracture pattern of cylinder 1
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3
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Compressive strength of cylinder 2
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7000.0 psi
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Compressive strength of cylinder 3
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7000 psi
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Type of fracture pattern of cylinder 2
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3
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Type of fracture pattern of cylinder 3
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3
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Comment on any defect in either specimen or caps (Max 250 Characters)
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Strength of sample 2 & 3 is > 7000 psi. Machine capacity is 7000 psi.
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Correction factor for cylinder 1
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1
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Correction factor for cylinder 2
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1
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Correction factor for cylinder 3
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1
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Age of specimen
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40 days
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Age of specimen in hours
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no data0 hours
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Serial number of delivery ticket, if available
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no data
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