Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001329 DEA: 100X7404 EFIS: 1013000008
QA Service Level: 1
DIST-CO-RTE-PM: 10-CAL-12-17.1/17.5
Work Description: BRIDGE REPLACEMENT.
Location Description: CALAVERAS COUNTY NEAR SAN ANDREAS FROM 0.2 MILE WEST OF NORTH FORK CALAVERAS RIVER BRIDGE TO 0.2 MILE EAST OF NORTH CALAVERAS RIVER BRIDGE
Contractor Name: STEELHEAD CONSTRUCTORS JV
Contractor Address: 2940 INNSBRUCK DR, REDDING, CA, 96003
Resident Engineer: Elaine Yip Structure Rep.: Ron Matin
DIME Sample ID: 2026-01-20-7
TL Number from the TL Form:
Sample Submitted By Organization: Con-Fab California Corporation - Lathrop
Sample Organization Contact: (209) 249-4700
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 01/20/2026
Date that the sample was received by the laboratory/organization performing the testing: 01/20/2026
The quantity of what the sample constitutes: 1 Bucket of 1/2", 1 Bucket of 3/8", One Bucket of Sand
A brief description of the sample: 1 Bucket of 1/2", 1 Bucket of 3/8", One Bucket of Sand
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: ConFab Lathrop
Source Identification (SMARA, name of Pit or Job Site): Confab California Lathrop
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Stockpile @ Plant
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
DIME Test ID: 2026-01-20-7-1
Test Method: ASTM C566-19: Standard Test Method for Total Evaporable Moisture Content of Aggregate by Drying
Verified Date: 01/20/2026
Date Tested: 01/20/2026
Submitted By Organization: Con-Fab California Corporation - Lathrop
Organization Address: 1910 Lathrop Road,
Organization City: Lathrop
Organization State: CA
Organization Zipcode: 95330
Organization Email: dannyc@confabca.com
Organization Phone: (209) 249-4717
General Comments for this Test: Sand 4.65%, 1/2" 0.82%, 3/8" 0.70%
Test Result Compliance:
Additional Comments When Verified:
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Total evaporable moisture content
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4.6 %
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