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Sample Record for 2024-10-16-25

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

Project Information

Project ID: 995286 DEA: 042Q5704 EFIS: 0419000026 QA Service Level: 1
DIST-CO-RTE-PM: 04-SCL-101,680-Var
Work Description: REPLACE STORMWATER PUMPS AND CONSTRUCT DRAINAGE BOXES.
Location Description: SANTA CLARA COUNTY IN AND NEAR MORGAN HILL AND SAN JOSE AT VARIOUS LOCATIONS
Contractor Name: DISNEY CONSTRUCTION, INC.
Contractor Address: 533 airport Blvd, Suite 120, Burlingame, CA 94010
Resident Engineer: Nim Patel Structure Rep.: Steve Gong

Sample Information

DIME Sample ID: 2024-10-16-25
TL Number from the TL Form:
Sample Submitted By Organization: Structure Cast
Sample Organization Contact: (661) 301-2624
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 10/16/2024
Date that the sample was received by the laboratory/organization performing the testing: 10/16/2024
The quantity of what the sample constitutes: 45 yd
A brief description of the sample: 4x8 concrete cylinders
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: StructureCast

Material Information

The concrete mix design number: 8.5SCC
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 13661
Concrete batch plant: StructureCast
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: By formwork at precast plant
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 3

DIME Test ID: 2024-10-16-25-1
Test Method: ASTM C1611-21: Standard Test Method for Slump Flow of Self-Consolidating Concrete
Submitted By Organization: Structure Cast
Organization Address: 8261 McCutchen Road ,
Organization City: Bakersfield
Organization State: CA
Organization Zipcode: 93311
Organization Email: brent@structurecast.com
Organization Phone: (661) 717-5464
Data has not been verified.

Test 2 of 3

DIME Test ID: 2024-10-16-25-2
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Submitted By Organization: Structure Cast
Organization Address: 8261 McCutchen Road ,
Organization City: Bakersfield
Organization State: CA
Organization Zipcode: 93311
Organization Email: brent@structurecast.com
Organization Phone: (661) 717-5464
Data has not been verified.

Test 3 of 3

DIME Test ID: 2024-10-16-25-3
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Submitted By Organization: Structure Cast
Organization Address: 8261 McCutchen Road ,
Organization City: Bakersfield
Organization State: CA
Organization Zipcode: 93311
Organization Email: brent@structurecast.com
Organization Phone: (661) 717-5464
Data has not been verified.