Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001219 DEA: 021J8904 EFIS: 0221000006
QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA-5-R30.5/R31.0
Work Description: REPLACE PAVEMENT AND PLACE POLYESTER CONCRETE OVERLAY.
Location Description: SHASTA COUNTY NEAR O\'BRIEN FROM 0.1 MILE SOUTH OF TUNNEL GULCH VIADUCT TO THE O\'BRIEN REST AREA
Contractor Name: MCCUEN CONSTRUCTION, INC.
Contractor Address: 3269 SWETZER ROAD, Loomis CA 95650
Resident Engineer: Kyle Higgins Structure Rep.: Chris Brace
DIME Sample ID: 2025-10-23-90
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: 10/23/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/23/2025
The quantity of what the sample constitutes: 9
A brief description of the sample: 4 x 8 Concrete Cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 80373-1 TP Set 1
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Precision Concrete Materials
The concrete mix design number: 80373-1 TP
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 0
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: N/B RTE 5, Shasta County, Departure Slab, Lane 1
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2025-10-23-90-1
Test Method: CTM 557-June 2020: Method of Test for Temperature of Freshly Mixed Hydraulic Cement Concrete
Verified Date: 04/09/2026
Date Tested: 10/24/2025
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
DIME Test ID: 2025-10-23-90-2
Test Method: CTM 518-June 2010: Method of Test for Unit Weight of Fresh Concrete
Verified Date: 04/09/2026
Date Tested: 10/24/2025
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
|
Unit weight of the concrete
|
140 lb/ft^3
|
|
Cement content
|
no data0 lb/yd^3
|
DIME Test ID: 2025-10-23-90-3
Test Method: CTM 504-June 2010: Method of Test for Determining Air Content of Freshly Mixed Concrete by the Pressure Method
Verified Date: 04/09/2026
Date Tested: 10/24/2025
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
DIME Test ID: 2025-10-23-90-4
Test Method: CTM 533-June 2010: Method of Test for Ball Penetration in Fresh Portland Cement Concrete
Verified Date: 04/09/2026
Date Tested: 10/24/2025
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
|
Ball penetration in freshly mixed concrete (average)
|
4 inch
|
DIME Test ID: 2025-10-23-90-5
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 04/09/2026
Date Tested: 10/24/2025
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
|
Unit system used?
|
US Units
|
|
Number of specimens
|
3
|
|
Test performed
|
With no density determined
|
|
Capped in accordance with?
|
ASTM C1231 - Unbonded Elastomeric Pad Cap
|
|
Average diameter of cylinder 1
|
4.01 in
|
|
Average diameter of cylinder 2
|
4.01 in
|
|
Average diameter of cylinder 3
|
4.01 in
|
|
Cross sectional area of cylinder 1
|
12.63 in^2
|
|
Cross sectional area of cylinder 2
|
12.63 in^2
|
|
Cross sectional area of cylinder 3
|
12.63 in^2
|
|
Compressive strength (to nearest 10 psi)
|
1500 psi
|
|
Maximum load on cylinder 1
|
17470 lb
|
|
Maximum load on cylinder 2
|
19320 lb
|
|
Maximum load on cylinder 3
|
20170 lb
|
|
Type of fracture pattern of cylinder 1
|
5
|
|
Type of fracture pattern of cylinder 2
|
5
|
|
Type of fracture pattern of cylinder 3
|
5
|
|
Comment on any defect in either specimen or caps (Max 250 Characters)
|
no data
|
|
Correction factor for cylinder 1
|
1
|
|
Correction factor for cylinder 2
|
1
|
|
Correction factor for cylinder 3
|
1
|
|
Age of specimen
|
no data0 days
|
|
Age of specimen in hours
|
4 hours
|
DIME Test ID: 2025-10-23-90-6
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 04/09/2026
Date Tested: 10/27/2025
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
|
Unit system used?
|
US Units
|
|
Number of specimens
|
3
|
|
Test performed
|
With no density determined
|
|
Capped in accordance with?
|
ASTM C1231 - Unbonded Elastomeric Pad Cap
|
|
Average diameter of cylinder 1
|
4.00 in
|
|
Average diameter of cylinder 2
|
4.00 in
|
|
Average diameter of cylinder 3
|
4.00 in
|
|
Cross sectional area of cylinder 1
|
12.57 in^2
|
|
Cross sectional area of cylinder 2
|
12.57 in^2
|
|
Cross sectional area of cylinder 3
|
12.57 in^2
|
|
Compressive strength (to nearest 10 psi)
|
3620 psi
|
|
Maximum load on cylinder 1
|
46900 lb
|
|
Maximum load on cylinder 2
|
45230 lb
|
|
Maximum load on cylinder 3
|
44470 lb
|
|
Type of fracture pattern of cylinder 1
|
2
|
|
Type of fracture pattern of cylinder 2
|
3
|
|
Type of fracture pattern of cylinder 3
|
3
|
|
Comment on any defect in either specimen or caps (Max 250 Characters)
|
no data
|
|
Correction factor for cylinder 1
|
1
|
|
Correction factor for cylinder 2
|
1
|
|
Correction factor for cylinder 3
|
1
|
|
Age of specimen
|
3 days
|
|
Age of specimen in hours
|
no data0 hours
|
DIME Test ID: 2025-10-23-90-7
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 04/09/2026
Date Tested: 11/21/2025
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
|
Unit system used?
|
US Units
|
|
Number of specimens
|
3
|
|
Test performed
|
With no density determined
|
|
Capped in accordance with?
|
ASTM C1231 - Unbonded Elastomeric Pad Cap
|
|
Average diameter of cylinder 1
|
4.00 in
|
|
Average diameter of cylinder 2
|
4.00 in
|
|
Average diameter of cylinder 3
|
4.00 in
|
|
Cross sectional area of cylinder 1
|
12.57 in^2
|
|
Cross sectional area of cylinder 2
|
12.57 in^2
|
|
Cross sectional area of cylinder 3
|
12.57 in^2
|
|
Compressive strength (to nearest 10 psi)
|
4270 psi
|
|
Maximum load on cylinder 1
|
53530 lb
|
|
Maximum load on cylinder 2
|
54990 lb
|
|
Maximum load on cylinder 3
|
52430 lb
|
|
Type of fracture pattern of cylinder 1
|
3
|
|
Type of fracture pattern of cylinder 2
|
3
|
|
Type of fracture pattern of cylinder 3
|
3
|
|
Comment on any defect in either specimen or caps (Max 250 Characters)
|
no data
|
|
Correction factor for cylinder 1
|
1
|
|
Correction factor for cylinder 2
|
1
|
|
Correction factor for cylinder 3
|
1
|
|
Age of specimen
|
28 days
|
|
Age of specimen in hours
|
no data0 hours
|
