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Sample Record for 2025-02-27-8

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Project Information

Project ID: 994857 DEA: 010H6104 EFIS: 0117000241 QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-36-13.5/R36.1
Work Description: COLD PLANE AND OVERLAY HMA, & REPLACE GUARDRAILS.
Location Description: HUMBOLDT COUNTY AT AND NEAR BRIDGEVILLE FROM 3.4 MILES WEST OF GRIZZLY CREEK BRIDGE TO 0.8 MILE EAST OF SOUTH FORK VAN DUZEN RIVER
Contractor Name: MERCER FRASER COMPANY
Contractor Address: PO Box 1006, Eureka, CA 95502
Resident Engineer: Joaquin Rodriquez Structure Rep.: Shantanu Nalawade

Sample Information

DIME Sample ID: 2025-02-27-8
TL Number from the TL Form:
Sample Submitted By Organization: CT D01 - District 1 Materials Laboratory
Sample Organization Contact: (707) 496-0974
Type of Sample: Acceptance
Type of Material: Concrete
Sample Taken Date: 02/27/2025
Date that the sample was received by the laboratory/organization performing the testing: 02/28/2025
The quantity of what the sample constitutes: 30 CY
A brief description of the sample: Type II Cement
From where was the sample collected: Job Site
Laboratory sample identification: 0377
Structure unique identifier: 04-0119
Structure name: South Fork Van Duzen River Bridge
The fabricator/manufacturer/facility name: Mercer Fraser - Fortuna

Material Information

The concrete mix design number: MF CL 1 .40 SLAG AE
The truck number from where the sample was collected: 692
The batch plant ticket number from where the sample was collected: 109121
Concrete batch plant: Mercer Fraser Fortuna concrete plant
The fabricator/manufacturer designation for the sample: 53768
A detailed description of where the material sample was collected: Ready Mix Chute
Where the material sample would have been placed if not sampled: WB approach barrier slab
From Lot No.:
Bag Lot No.:
Test results on following page(s): 5

Test Results

Test 1 of 5

DIME Test ID: 2025-02-27-8-1
Test Method: CTM 556-January 2018: Method of Test for Slump of Fresh Portland Cement Concrete
Verified Date: 03/24/2025
Date Tested: 02/27/2025
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1050 River Ranch Road,
Organization City: Fortuna
Organization State: California
Organization Zipcode: 95540
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Slump 3.5 inch

Test 2 of 5

DIME Test ID: 2025-02-27-8-2
Test Method: CTM 557-July 2012: Method of Test for Temperature of Freshly Mixed Portland Cement Concrete
Verified Date: 04/15/2025
Date Tested: 02/27/2025
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1050 River Ranch Road,
Organization City: Fortuna
Organization State: California
Organization Zipcode: 95540
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Temperature of the freshly mixed concrete 62 F

Test 3 of 5

DIME Test ID: 2025-02-27-8-3
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 03/05/2025
Date Tested: 03/05/2025
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1050 River Ranch Road,
Organization City: Fortuna
Organization State: California
Organization Zipcode: 95540
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
General Comments for this Test: 6 day break 3/5/25 1 cylinder
Test Result Compliance:
Additional Comments When Verified:
Unit system used? US Units
Number of specimens 1
Test performed With no density determined
Capped in accordance with? ASTM C1231 - Unbonded Elastomeric Pad Cap
Average diameter of cylinder 1 4.00 in
Compressive strength of cylinder (to nearest 10 psi) 4850 psi
Maximum load on cylinder 1 60910 lb
Type of fracture pattern of cylinder 1 1
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Age of specimen 6 days
Age of specimen in hours no data0 hours

Test 4 of 5

DIME Test ID: 2025-02-27-8-4
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 03/13/2025
Date Tested: 03/13/2025
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1050 River Ranch Road,
Organization City: Fortuna
Organization State: California
Organization Zipcode: 95540
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
General Comments for this Test: 14 day break 3/13/25 1 cylinder
Test Result Compliance:
Additional Comments When Verified:
Unit system used? US Units
Number of specimens 1
Test performed With no density determined
Capped in accordance with? ASTM C1231 - Unbonded Elastomeric Pad Cap
Average diameter of cylinder 1 4.00 in
Compressive strength of cylinder (to nearest 10 psi) 5010 psi
Maximum load on cylinder 1 62980 lb
Type of fracture pattern of cylinder 1 1
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Age of specimen 14 days
Age of specimen in hours no data0 hours

Test 5 of 5

DIME Test ID: 2025-02-27-8-5
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 03/27/2025
Date Tested: 03/27/2025
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1050 River Ranch Road,
Organization City: Fortuna
Organization State: California
Organization Zipcode: 95540
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
General Comments for this Test: 28 day break 3/27/25 1 cylinder
Test Result Compliance:
Additional Comments When Verified:
Unit system used? US Units
Number of specimens 1
Test performed With no density determined
Capped in accordance with? ASTM C1231 - Unbonded Elastomeric Pad Cap
Average diameter of cylinder 1 4.00 in
Compressive strength of cylinder (to nearest 10 psi) 5640 psi
Maximum load on cylinder 1 70860 lb
Type of fracture pattern of cylinder 1 1
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Age of specimen 28 days
Age of specimen in hours no data0 hours