Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000015 DEA: 033H8304 EFIS: 0318000075
QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-49-3.5/7.5
Work Description: CONSTRUCT SIDEWALKS, CURB RAMPS AND DRAINAGE FACILITIES. CONSTRUCT PEDESTRIAN BRIDGE
Location Description: PLACER COUNTY IN AND NEAR AUBURN FROM 0.3 MILE NORTH OF ROUTE 80/49 SEPARATION TO 0.1 MILE NORTH OF DRY CREEK ROAD
Contractor Name: PACIFIC INFRASTRUCTURE CONSTRUCTION, LLC
Contractor Address: 871 COTTING COURT STE A, VACAVILLE CA 95688
Resident Engineer: Lucas Price Structure Rep.: Eric Duray
DIME Sample ID: 2025-09-19-70
TL Number from the TL Form:
Sample Submitted By Organization: Blackburn Consulting
Sample Organization Contact: (916) 375-8706
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 09/19/2025
Date that the sample was received by the laboratory/organization performing the testing: 09/20/2025
The quantity of what the sample constitutes: 1 day placement
A brief description of the sample: PCC Concrete
From where was the sample collected: Job Site
Laboratory sample identification: 3432
Structure unique identifier:
Structure name: Retaining Wall 1 - Wall Pour # 2
The fabricator/manufacturer/facility name: Folsom Ready Mix
The concrete mix design number: C62A4M6
The truck number from where the sample was collected: 87
The batch plant ticket number from where the sample was collected: 4083424
Concrete batch plant: Roseville
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: The hopper of the concrete pump
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2025-09-19-70-1
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Submitted By Organization: Blackburn Consulting
Organization Address: 2491 Boatman Avenue,
Organization City: West Sacrametno
Organization State: CA
Organization Zipcode: 95691
Organization Email: brycem@blackburnconsulting.com
Organization Phone: (916) 375-8706
Data has not been verified.
DIME Test ID: 2025-09-19-70-2
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Submitted By Organization: Blackburn Consulting
Organization Address: 2491 Boatman Avenue,
Organization City: West Sacrametno
Organization State: CA
Organization Zipcode: 95691
Organization Email: brycem@blackburnconsulting.com
Organization Phone: (916) 375-8706
Data has not been verified.
DIME Test ID: 2025-09-19-70-3
Test Method: ASTM C231-17a: Standard Test Method for Air Content of Freshly Mixed Concrete by the Pressure Method
Submitted By Organization: Blackburn Consulting
Organization Address: 2491 Boatman Avenue,
Organization City: West Sacrametno
Organization State: CA
Organization Zipcode: 95691
Organization Email: brycem@blackburnconsulting.com
Organization Phone: (916) 375-8706
Data has not been verified.
DIME Test ID: 2025-09-19-70-4
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Submitted By Organization: Blackburn Consulting
Organization Address: 2491 Boatman Avenue,
Organization City: West Sacrametno
Organization State: CA
Organization Zipcode: 95691
Organization Email: brycem@blackburnconsulting.com
Organization Phone: (916) 375-8706
Data has not been verified.
DIME Test ID: 2025-09-19-70-5
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Submitted By Organization: Blackburn Consulting
Organization Address: 2491 Boatman Avenue,
Organization City: West Sacrametno
Organization State: CA
Organization Zipcode: 95691
Organization Email: brycem@blackburnconsulting.com
Organization Phone: (916) 375-8706
Data has not been verified.
DIME Test ID: 2025-09-19-70-6
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Submitted By Organization: Blackburn Consulting
Organization Address: 2491 Boatman Avenue,
Organization City: West Sacrametno
Organization State: CA
Organization Zipcode: 95691
Organization Email: brycem@blackburnconsulting.com
Organization Phone: (916) 375-8706
Data has not been verified.
