Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993678 DEA: 042Q8004 EFIS: 0419000050 COOP: 042836,042944
QA Service Level: 1
DIST-CO-RTE-PM: 04-SM-101,92-US 101 & SR 92-10.9/12.1 & 11.8/13.4
Work Description: US 101/SR 92 INTERCHANGE AREA IMPROVEMENT :PROJECT WILL CONSTRUCT CONGESTION RELIEF IMPROVEMENTS AT THE US 101/SR 92 INTERCHANGE AREA.
Location Description:
Contractor Name: GORDON N. BALL, INC.
Contractor Address: 333 CAMILLE AVENUE, ALAMO, CA 94507
Resident Engineer: Mohamed Fouad Structure Rep.: Bryan Nagid
DIME Sample ID: 2025-10-01-65
TL Number from the TL Form:
Sample Submitted By Organization: CT SC - 3674 - Pacifica 2
Sample Organization Contact: (510) 714-7639
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 10/01/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/20/2025
The quantity of what the sample constitutes: 176 CY
A brief description of the sample: Bent 17 CIDH Concrete
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier: 35-0252L
Structure name:
The fabricator/manufacturer/facility name: Central Concrete
The concrete mix design number: DDGPV2Q3
The truck number from where the sample was collected: 3
The batch plant ticket number from where the sample was collected: 915804
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Concrete sample from wheel barrow
Where the material sample would have been placed if not sampled: CIDH Pile
From Lot No.:
Bag Lot No.:
DIME Test ID: 2025-10-01-65-1
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 10/29/2025
Date Tested: 10/29/2025
Submitted By Organization: Kleinfelder - Hayward
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:
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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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7410 psi
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Maximum load on cylinder 1
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89980 lb
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Maximum load on cylinder 2
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93690 lb
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Maximum load on cylinder 3
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95623 lb
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Compressive strength of cylinder 1
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7158.3 psi
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Type of fracture pattern of cylinder 1
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5
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Compressive strength of cylinder 2
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7453.5 psi
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Compressive strength of cylinder 3
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7607.2 psi
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Type of fracture pattern of cylinder 2
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5
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Type of fracture pattern of cylinder 3
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5
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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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