Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994901 DEA: 112T3434 EFIS: 1120000081
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-805-5.1/8.3
Work Description: SOUNDWALLS, WIDEN FREEWAY, STRUCTURES, LANDSCAPE AND ELECTRICAL.
Location Description: SAN DIEGO COUNTY IN CHULA VISTA FROM PALOMAR STREET OVERCROSSING TO 0.5 MILE NORTH OF BONITA ROAD UNDERCROSSING
Contractor Name: WALSH CONSTRUCTION COMPANY II, LLC
Contractor Address: 1260 Corona Pointe Court #201
Resident Engineer: Tan Cao Structure Rep.: Daniela Gomez
DIME Sample ID: 2026-01-15-2
TL Number from the TL Form:
Sample Submitted By Organization: CT D11 - District 11 Materials Laboratory
Sample Organization Contact: (858) 518-8709
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 01/15/2026
Date that the sample was received by the laboratory/organization performing the testing: 01/15/2026
The quantity of what the sample constitutes: Field Sample
A brief description of the sample: Field Sample
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Associated Otay
The concrete mix design number: 55723740
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 1
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Field Sample
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2026-01-15-2-1
Test Method: CTM 504-June 2010: Method of Test for Determining Air Content of Freshly Mixed Concrete by the Pressure Method
Verified Date: 01/16/2026
Date Tested: 01/15/2026
Submitted By Organization: CT D11 - District 11 Materials Laboratory
Organization Address: 4050 Taylor Street,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92110
Organization Email: benjamin.haney@dot.ca.gov
Organization Phone: (858) 688-1595
General Comments for this Test: Target 1.5 %
Test Result Compliance: complies
Additional Comments When Verified:
DIME Test ID: 2026-01-15-2-2
Test Method: CTM 518-June 2010: Method of Test for Unit Weight of Fresh Concrete
Submitted By Organization: CT D11 - District 11 Materials Laboratory
Organization Address: 4050 Taylor Street,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92110
Organization Email: benjamin.haney@dot.ca.gov
Organization Phone: (858) 688-1595
Data has not been verified.
DIME Test ID: 2026-01-15-2-3
Test Method: CTM 556-January 2018: Method of Test for Slump of Fresh Portland Cement Concrete
Verified Date: 01/16/2026
Date Tested: 01/15/2026
Submitted By Organization: CT D11 - District 11 Materials Laboratory
Organization Address: 4050 Taylor Street,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92110
Organization Email: benjamin.haney@dot.ca.gov
Organization Phone: (858) 688-1595
General Comments for this Test: Complies Target 4.0 +/- 1.5 % Tested 3.5%
Test Result Compliance: complies
Additional Comments When Verified:
DIME Test ID: 2026-01-15-2-4
Test Method: CTM 557-June 2020: Method of Test for Temperature of Freshly Mixed Hydraulic Cement Concrete
Verified Date: 01/16/2026
Date Tested: 01/15/2026
Submitted By Organization: CT D11 - District 11 Materials Laboratory
Organization Address: 4050 Taylor Street,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92110
Organization Email: benjamin.haney@dot.ca.gov
Organization Phone: (858) 688-1595
General Comments for this Test: Complies
Test Result Compliance: not applicable
Additional Comments When Verified:
