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Sample Record for 2025-09-12-12

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

Project Information

Project ID: 215620 DEA: 01436404 EFIS: 0100000193 QA Service Level: 1
DIST-CO-RTE-PM: 01-DN-101-35.8/36.5
Work Description: Dr. Fine Bridge Replacement
Location Description: DR. FINE BRIDGE REPLACEMENT FROM LAKE EARL DR TO S FRED D. HAIGHT DR ON HWY 101 ACROSS SMITH RIVER.
Contractor Name: MCM Construction
Contractor Address: PO Box 620, North Highlands, Ca 95660
Resident Engineer: Clayton Malmberg Structure Rep.: Brian Cinkutis

Sample Information

DIME Sample ID: 2025-09-12-12
TL Number from the TL Form:
Sample Submitted By Organization: CT D01 - Crescent City Field Laboratory
Sample Organization Contact: (707) 496-5581
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 09/12/2025
Date that the sample was received by the laboratory/organization performing the testing: 09/15/2025
The quantity of what the sample constitutes: 700 CY
A brief description of the sample: Stem and soffit pour 6
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Tidewater Bar Pit

Material Information

The concrete mix design number: SR-minor structure NA
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: xxxx
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Back of truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2025-09-12-12-1
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 09/19/2025
Date Tested: 09/19/2025
Submitted By Organization: CT D01 - Crescent City Field Laboratory
Organization Address: 1444 Parkway Dr.,
Organization City: Crescent City
Organization State: CA
Organization Zipcode: 95531
Organization Email: clayton.malmberg@dot.ca.gov
Organization Phone: (707) 496-5581
General Comments for this Test: 7 day break
Test Result Compliance:
Additional Comments When Verified:
Unit system used? US Units
Number of specimens 3
Test performed With no density determined
Capped in accordance with? ASTM C1231 - Unbonded Elastomeric Pad Cap
Average diameter of cylinder 1 4.00 in
Average diameter of cylinder 2 4.00 in
Average diameter of cylinder 3 4.00 in
Cross sectional area of cylinder 1 12.57 in^2
Cross sectional area of cylinder 2 12.57 in^2
Cross sectional area of cylinder 3 12.57 in^2
Compressive strength (to nearest 10 psi) 2720 psi
Maximum load on cylinder 1 34078 lb
Maximum load on cylinder 2 34066 lb
Maximum load on cylinder 3 34347 lb
Compressive strength of cylinder 1 2711.1 psi
Type of fracture pattern of cylinder 1 2
Compressive strength of cylinder 2 2710.1 psi
Compressive strength of cylinder 3 2732.5 psi
Type of fracture pattern of cylinder 2 2
Type of fracture pattern of cylinder 3 2
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Correction factor for cylinder 2 1
Correction factor for cylinder 3 1
Age of specimen 7 days
Age of specimen in hours no data0 hours

Test 2 of 3

DIME Test ID: 2025-09-12-12-2
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 09/26/2025
Date Tested: 09/26/2025
Submitted By Organization: CT D01 - Crescent City Field Laboratory
Organization Address: 1444 Parkway Dr.,
Organization City: Crescent City
Organization State: CA
Organization Zipcode: 95531
Organization Email: clayton.malmberg@dot.ca.gov
Organization Phone: (707) 496-5581
General Comments for this Test: 14 day break
Test Result Compliance:
Additional Comments When Verified:
Unit system used? US Units
Number of specimens 3
Test performed With no density determined
Capped in accordance with? ASTM C1231 - Unbonded Elastomeric Pad Cap
Average diameter of cylinder 1 4.00 in
Average diameter of cylinder 2 4.00 in
Average diameter of cylinder 3 4.00 in
Cross sectional area of cylinder 1 12.57 in^2
Cross sectional area of cylinder 2 12.57 in^2
Cross sectional area of cylinder 3 12.57 in^2
Compressive strength (to nearest 10 psi) 3780 psi
Maximum load on cylinder 1 47388 lb
Maximum load on cylinder 2 47211 lb
Maximum load on cylinder 3 48132 lb
Compressive strength of cylinder 1 3769.9 psi
Type of fracture pattern of cylinder 1 2
Compressive strength of cylinder 2 3755.8 psi
Compressive strength of cylinder 3 3829.1 psi
Type of fracture pattern of cylinder 2 2
Type of fracture pattern of cylinder 3 2
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Correction factor for cylinder 2 1
Correction factor for cylinder 3 1
Age of specimen 14 days
Age of specimen in hours no data0 hours

Test 3 of 3

DIME Test ID: 2025-09-12-12-3
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 10/10/2025
Date Tested: 10/10/2025
Submitted By Organization: CT D01 - Crescent City Field Laboratory
Organization Address: 1444 Parkway Dr.,
Organization City: Crescent City
Organization State: CA
Organization Zipcode: 95531
Organization Email: clayton.malmberg@dot.ca.gov
Organization Phone: (707) 496-5581
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Unit system used? US Units
Number of specimens 3
Test performed With no density determined
Capped in accordance with? ASTM C1231 - Unbonded Elastomeric Pad Cap
Average diameter of cylinder 1 4.00 in
Average diameter of cylinder 2 4.00 in
Average diameter of cylinder 3 4.00 in
Cross sectional area of cylinder 1 12.57 in^2
Cross sectional area of cylinder 2 12.57 in^2
Cross sectional area of cylinder 3 12.57 in^2
Compressive strength (to nearest 10 psi) 5400 psi
Maximum load on cylinder 1 66994 lb
Maximum load on cylinder 2 67745 lb
Maximum load on cylinder 3 68998 lb
Compressive strength of cylinder 1 5329.7 psi
Type of fracture pattern of cylinder 1 2
Compressive strength of cylinder 2 5389.4 psi
Compressive strength of cylinder 3 5489.1 psi
Type of fracture pattern of cylinder 2 2
Type of fracture pattern of cylinder 3 2
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Correction factor for cylinder 2 1
Correction factor for cylinder 3 1
Age of specimen 28 days
Age of specimen in hours no data0 hours