Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001940 DEA: 023J52U4 EFIS: 0225000084
QA Service Level: 1
DIST-CO-RTE-PM: 02-TEH-36-15.7/16.4
Work Description: Horse Gulch Combined
Location Description:
Contractor Name: JF Shea Constrcution
Contractor Address: 17400 Clear Creek Road, Redding, CA 96001
Resident Engineer: Damion Farley Structure Rep.: Unknown
DIME Sample ID: 2026-04-10-11
TL Number from the TL Form:
Sample Submitted By Organization: Precast Unlimited Inc.
Sample Organization Contact: (530) 243-6477
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 04/10/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/09/2026
The quantity of what the sample constitutes: 5 CY
A brief description of the sample: Ready Mix Concrete
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Precast Unlimited Inc.
The concrete mix design number: CT-850SL
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 113592
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Back of Truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2026-04-10-11-1
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Verified Date: 04/10/2026
Date Tested: 04/10/2026
Submitted By Organization: Precast Unlimited Inc.
Organization Address: 16538 Clear Creek Rd.,
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: chase@precastunlimited.com
Organization Phone: 1 (530) 243-6477
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
DIME Test ID: 2026-04-10-11-2
Test Method: ASTM C138-17a: Standard Test Method for Density (Unit Weight), Yield, and Air Content (Gravimetric) of Concrete
Verified Date: 04/10/2026
Date Tested: 04/10/2026
Submitted By Organization: Precast Unlimited Inc.
Organization Address: 16538 Clear Creek Rd.,
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: chase@precastunlimited.com
Organization Phone: 1 (530) 243-6477
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Identification of concrete represented by the sample
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113592
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Volume of the measure
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0.25 ft^3
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Density of concrete
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146.8 lb/ft^3
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Yield of concrete
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no data
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Relative yield of the batch
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no data
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Cement content
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no data
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Air content
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no data
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DIME Test ID: 2026-04-10-11-3
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 04/10/2026
Date Tested: 04/10/2026
Submitted By Organization: Precast Unlimited Inc.
Organization Address: 16538 Clear Creek Rd.,
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: chase@precastunlimited.com
Organization Phone: 1 (530) 243-6477
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
DIME Test ID: 2026-04-10-11-4
Test Method: ASTM C231-17a: Standard Test Method for Air Content of Freshly Mixed Concrete by the Pressure Method
Verified Date: 04/10/2026
Date Tested: 04/10/2026
Submitted By Organization: Precast Unlimited Inc.
Organization Address: 16538 Clear Creek Rd.,
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: chase@precastunlimited.com
Organization Phone: 1 (530) 243-6477
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
