Sample Record for 2025-09-07-6
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994310 DEA: 034F6504 EFIS: 0314000233
QA Service Level: 1
DIST-CO-RTE-PM: 03-YOL-50,80-0.0/2.5,4.1/R11.4
Work Description: CRCP, HMA (TYPE A), RDWY EXC, CLASS 2 AB, FIBER OPTIC CABLE SYSTEMS.
Location Description: YOLO COUNTY IN AND NEAR WEST SACRAMENTO ON ROUTE 80 FROM 1.7 MILES EAST OF MACE BOULEVARD OVERCROSSING TO SACRAMENTO RIVER BRIDGE AND OVERHEAD (BRYTE BEND) AND ON ROUTE 50 FROM ROUTE 80 JUNCTION TO JEFFERSON BOULEVARD UNDERCROSSING
Contractor Name: Flat-Iron Teichert A Joint Venture
Contractor Address: 1200 Concord Avenue Suite 465, Concord, CA 94520
Resident Engineer: Mirak Mehari Structure Rep.: Brent Bullard
Sample Information
DIME Sample ID: 2025-09-07-6
TL Number from the TL Form:
Sample Submitted By Organization: CT SC - 3665 - Sacramento
Sample Organization Contact: (916) 768-8293
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 09/07/2025
Date that the sample was received by the laboratory/organization performing the testing: 09/08/2025
The quantity of what the sample constitutes: 3 - 4x8 cylinders
A brief description of the sample: Rapid Set Concrete
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier: 22-0149
Structure name: Reed Ave UC
The fabricator/manufacturer/facility name: Cemex Sacramento
Material Information
The concrete mix design number: 1629682
The truck number from where the sample was collected: 72277
The batch plant ticket number from where the sample was collected: CEMEX Sacramento
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Back of Concrete Truck
Where the material sample would have been placed if not sampled: Abutment 3 Approach/Departure Slab
From Lot No.:
Bag Lot No.:
Test Results
