Sample Record for 2025-11-25-19
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000279 DEA: 023H70U4 EFIS: 0223000161
QA Service Level: 1
DIST-CO-RTE-PM: 02-TRI-299-15.0/25.7
Work Description: RHMA-G, HMA (TYPE A), COLD PLANE AC, & SOLDIER PILE RETAINING WALL.
Location Description: TRINITY COUNTY NEAR DEL LOMA FROM 1.0 MILE EAST OF TRINITY RIVER BRIDGE NO.05-0006 TO 0.1 MILE WEST OF PRAIRIE CREEK ROAD
Contractor Name: J.F. SHEA CONSTRUCTION, INC.
Contractor Address: Unknown
Resident Engineer: Edward Worden Structure Rep.: Mike Sears
Sample Information
DIME Sample ID: 2025-11-25-19
TL Number from the TL Form:
Sample Submitted By Organization: CT D01 - District 1 Materials Laboratory
Sample Organization Contact: (707) 496-0974
Type of Sample: Acceptance
Type of Material: Concrete
Sample Taken Date: 11/25/2025
Date that the sample was received by the laboratory/organization performing the testing: 11/26/2025
The quantity of what the sample constitutes: 250 cy
A brief description of the sample: Type II V
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Mercer Fraser Willow Crk
Material Information
The concrete mix design number: MF CL 1 .40 SLAG AE
The truck number from where the sample was collected: 700
The batch plant ticket number from where the sample was collected: 700162
Concrete batch plant: Mercer Fraser Willow Crk
The fabricator/manufacturer designation for the sample: Mercer Fraser
A detailed description of where the material sample was collected: Ready Mix Truck Chute
Where the material sample would have been placed if not sampled: Barrier slab
From Lot No.:
Bag Lot No.:
Test Results
Test 1 of 2
DIME Test ID: 2025-11-25-19-1
Test Method: CTM 557-July 2012: Method of Test for Temperature of Freshly Mixed Portland Cement Concrete
Verified Date: 11/26/2025
Date Tested: 11/25/2025
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1050 River Ranch Road,
Organization City: Fortuna
Organization State: California
Organization Zipcode: 95540
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
|
Temperature of the freshly mixed concrete
|
54 F
|
Test 2 of 2
DIME Test ID: 2025-11-25-19-2
Test Method: CTM 556-January 2018: Method of Test for Slump of Fresh Portland Cement Concrete
Verified Date: 11/26/2025
Date Tested: 11/25/2025
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1050 River Ranch Road,
Organization City: Fortuna
Organization State: California
Organization Zipcode: 95540
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| 2025-11-25-19-3 | CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders | 11/26/2025 | Not scheduled | Andrew Grinsell | CT D01 - District 1 Materials Laboratory | | |
151232
