Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215741 DEA: 01366004 EFIS: 0100000127
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-101-80.0/84.0
Work Description: Indianola Cutoff UC
Location Description: HUMBOLDT COUNTY NEAR EUREKA FROM EUREKA SLOUGH BRIDGE TO BAYSIDE CUTOFF
Contractor Name: Granite Construction Company
Contractor Address: 1324 S. State Street, Ukiah, CA 95482
Resident Engineer: Efren Banuelos Structure Rep.: Adlai Evans
DIME Sample ID: 2025-09-16-31
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: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 09/16/2025
Date that the sample was received by the laboratory/organization performing the testing: 04/17/2025
The quantity of what the sample constitutes: 144 CY
A brief description of the sample: Type II-V Cement
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier: 12-04-0314
Structure name: Indianola Cutoff UC
The fabricator/manufacturer/facility name: Eureka Ready mix
The concrete mix design number: E400FBR
The truck number from where the sample was collected: 95
The batch plant ticket number from where the sample was collected: 43549
Concrete batch plant: Arcata Eureka Ready Mix
The fabricator/manufacturer designation for the sample: Batch
A detailed description of where the material sample was collected: CHUTE FROM TRUCK
Where the material sample would have been placed if not sampled: Approach Slab North
From Lot No.:
Bag Lot No.:
DIME Test ID: 2025-09-16-31-1
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 10/14/2025
Date Tested: 10/14/2025
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 10/14/25
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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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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4270 psi
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Maximum load on cylinder 1
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55836 lb
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Maximum load on cylinder 2
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52706 lb
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Maximum load on cylinder 3
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52440 lb
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Type of fracture pattern of cylinder 1
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2
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Type of fracture pattern of cylinder 2
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2
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Type of fracture pattern of cylinder 3
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2
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Comment on any defect in either specimen or caps (Max 250 Characters)
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no data
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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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28 days
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Age of specimen in hours
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no data0 hours
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DIME Test ID: 2025-09-16-31-2
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Verified Date: 09/17/2025
Date Tested: 09/16/2025
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: Ambient T = 60 degrees
Test Result Compliance: complies
Additional Comments When Verified:
DIME Test ID: 2025-09-16-31-3
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 09/17/2025
Date Tested: 09/16/2025
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: complies
Additional Comments When Verified:
