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Sample Record for 2025-10-08-21

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

Project Information

Project ID: 1000731 DEA: 042Q4404 EFIS: 0419000013 QA Service Level: 1
DIST-CO-RTE-PM: 04-SON-121-6.5,8.4
Work Description: REMOVE BR AND AC SURF, CONSTRUCT BR DECK, RAILING AND POLYESTER CONC.
Location Description: SONOMA COUNTY NEAR SONOMA AT YELLOW CREEK BRIDGE AND AT ARROYO SECO BRIDGE
Contractor Name: GORDON N. BALL, INC.
Contractor Address: Unknown
Resident Engineer: Fabio La Serna Structure Rep.: Jeremy Light

Sample Information

DIME Sample ID: 2025-10-08-21
TL Number from the TL Form:
Sample Submitted By Organization: CT SC - 3672 - Novato Field Office
Sample Organization Contact: (916) 621-8033
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 10/08/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/08/2025
The quantity of what the sample constitutes: 28 CY
A brief description of the sample: Rapid Strength Concrete
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier: 20-0023
Structure name: Arroyo Seco bridge, Approach Slab, Schellville Rd (West Side)
The fabricator/manufacturer/facility name: Shamrock Materials Inc

Material Information

The concrete mix design number: H7511503
The truck number from where the sample was collected: 2421
The batch plant ticket number from where the sample was collected: 411175
Concrete batch plant: 138 Petaluma
The fabricator/manufacturer designation for the sample: Shamrock Materials
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): 4

Test Results

Test 1 of 4

DIME Test ID: 2025-10-08-21-1
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Submitted By Organization: CT SC - 3672 - Novato Field Office
Organization Address: 384 Bel Marin Keys Boulevard, Suite 200,
Organization City: Novato
Organization State: CA
Organization Zipcode: 94949
Organization Email: josh.velono@dot.ca.gov
Organization Phone: (916) 621-8033
Data has not been verified.

Test 2 of 4

DIME Test ID: 2025-10-08-21-2
Test Method: ASTM C143-15a: Standard Test Method for Slump of Hydraulic-Cement Concrete
Submitted By Organization: CT SC - 3672 - Novato Field Office
Organization Address: 384 Bel Marin Keys Boulevard, Suite 200,
Organization City: Novato
Organization State: CA
Organization Zipcode: 94949
Organization Email: josh.velono@dot.ca.gov
Organization Phone: (916) 621-8033
Data has not been verified.

Test 3 of 4

DIME Test ID: 2025-10-08-21-3
Test Method: ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Verified Date: 10/10/2025
Date Tested: 10/10/2025
Submitted By Organization: CT HQ - Vallejo Field Laboratory
Organization Address: 690 Walnut,
Organization City: vallejo
Organization State: CA
Organization Zipcode: 94592
Organization Email: yannick.aranas@dot.ca.gov
Organization Phone: (916) 639-4315
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) 6650 psi
Maximum load on cylinder 1 81076 lb
Maximum load on cylinder 2 84533 lb
Maximum load on cylinder 3 85099 lb
Compressive strength of cylinder 1 6450.0 psi
Type of fracture pattern of cylinder 1 3
Compressive strength of cylinder 2 6725.0 psi
Compressive strength of cylinder 3 6770 psi
Type of fracture pattern of cylinder 2 3
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 2 days
Age of specimen in hours no data

Test 4 of 4

DIME Test ID: 2025-10-08-21-4
Test Method: ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Verified Date: 10/16/2025
Date Tested: 10/13/2025
Submitted By Organization: CT HQ - Vallejo Field Laboratory
Organization Address: 690 Walnut,
Organization City: vallejo
Organization State: CA
Organization Zipcode: 94592
Organization Email: yannick.aranas@dot.ca.gov
Organization Phone: (916) 639-4315
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) 7280 psi
Maximum load on cylinder 1 87990 lb
Maximum load on cylinder 2 96789 lb
Maximum load on cylinder 3 89900 lb
Compressive strength of cylinder 1 7000.0 psi
Type of fracture pattern of cylinder 1 5
Compressive strength of cylinder 2 7700.0 psi
Compressive strength of cylinder 3 7151.9 psi
Type of fracture pattern of cylinder 2 5
Type of fracture pattern of cylinder 3 5
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 5 days
Age of specimen in hours no data