Sample Record for 2025-07-26-17
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 995254 DEA: 040P9204 EFIS: 0418000026
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-680-6.4/6.6
Work Description: HMA AND RHMA SURFACING, DECK REPAIR, POLYESTER OVERLAY AND JOIN SEALS
Location Description: ALAMEDA COUNTY IN FREMONT FROM 0.1 MILE SOUTH OF MISSION SAN JOSE 680/238 SEPARATION TO 0.3 MILE NORTH OF MISSION SAN JOSE 680/238 SEPARATION
Contractor Name: MYERS & SONS CONSTRUCTION, LLC.
Contractor Address: 45 Morrison Avenue, Sacramento, CA 95838
Resident Engineer: Scott Sowko Structure Rep.: Jordan Jarosz
Sample Information
DIME Sample ID: 2025-07-26-17
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: 07/26/2025
Date that the sample was received by the laboratory/organization performing the testing: 07/27/2025
The quantity of what the sample constitutes: 9
A brief description of the sample: 4x8 Concrete Cylinders
From where was the sample collected: Job Site
Laboratory sample identification: Mix 675CTSRSC Set 3
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Myers and Sons Construction
Material Information
The concrete mix design number: 675CTSRSC
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: Load 19
Concrete batch plant:
The fabricator/manufacturer designation for the sample: Mix 675CTSRSC Set 3
A detailed description of where the material sample was collected: S/B RTE 680, Mission Bvld Overpass, Lane 1-4
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test Results
Test 1 of 6
DIME Test ID: 2025-07-26-17-1
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.
Test 2 of 6
DIME Test ID: 2025-07-26-17-2
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.
Test 3 of 6
DIME Test ID: 2025-07-26-17-3
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.
Test 4 of 6
DIME Test ID: 2025-07-26-17-4
Test Method: CTM 533-June 2010: Method of Test for Ball Penetration in 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.
Test 5 of 6
DIME Test ID: 2025-07-26-17-5
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.
Test 6 of 6
DIME Test ID: 2025-07-26-17-6
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.
