Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000403 DEA: 120K91U4 EFIS: 1222000031
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-91-R9.2/R11.4
Work Description: CONST BRIDGES, RW, SW, PAVEMENT, DRAINAGE AND ELECTRICAL SYSTEMS.
Location Description: ORANGE COUNTY IN ANAHEIM FROM 0.9 MILE WEST TO 1.3 MILES EAST OF LAKEVIEW AVENUE OVERCROSSING
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 16700 Valley View Avenue Suite 300
Resident Engineer: Steve Kinaly Structure Rep.: Wei-Jen Lee
DIME Sample ID: 2025-11-13-40
TL Number from the TL Form:
Sample Submitted By Organization: G3 Quality, Incorporated - Cerritos
Sample Organization Contact: (562) 321-9840
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 11/13/2025
Date that the sample was received by the laboratory/organization performing the testing: 11/14/2025
The quantity of what the sample constitutes: 12
A brief description of the sample: 4x8 cylinders
From where was the sample collected: Job Site
Laboratory sample identification: Mix 556300 Set 1
Structure unique identifier: 00-0000
Structure name: Abutment 3 footing Stage 1
The fabricator/manufacturer/facility name: Associated Ready Mix
The concrete mix design number: 556300
The truck number from where the sample was collected: Load 6
The batch plant ticket number from where the sample was collected: 0
Concrete batch plant:
The fabricator/manufacturer designation for the sample: Set 1
A detailed description of where the material sample was collected: Abutment 3 Footing Stage 1
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2025-11-13-40-1
Test Method: CTM 518-June 2010: Method of Test for Unit Weight of Fresh Concrete
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
Data has not been verified.
DIME Test ID: 2025-11-13-40-2
Test Method: CTM 504-June 2010: Method of Test for Determining Air Content of Freshly Mixed Concrete by the Pressure Method
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
Data has not been verified.
DIME Test ID: 2025-11-13-40-3
Test Method: CTM 556-January 2018: Method of Test for Slump of Fresh Portland Cement Concrete
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
Data has not been verified.
DIME Test ID: 2025-11-13-40-4
Test Method: CTM 557-June 2020: Method of Test for Temperature of Freshly Mixed Hydraulic Cement Concrete
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
Data has not been verified.
DIME Test ID: 2025-11-13-40-5
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
Data has not been verified.
DIME Test ID: 2025-11-13-40-6
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: 562-321-9853
Data has not been verified.
