Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000513 DEA: 020J8504 EFIS: 0219000168
QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-89-21/R34.622
Work Description: MCCLOUD CAPM - PAVEMENT REHABILITATION
Location Description: IN SISKIYOU COUNTY AT AND NEAR MCCLOUD FROM 0.1 MILE SOUTH OF MUD CREEK BRIDGE TO ROUTE 5
Contractor Name: TULLIS, INC.
Contractor Address: Unknown
Resident Engineer: Austin Henry Structure Rep.: Unknown
DIME Sample ID: 2026-06-22-6
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: 06/22/2026
Date that the sample was received by the laboratory/organization performing the testing: 06/22/2026
The quantity of what the sample constitutes: 1 cubic ft. of Concrete for Testing
A brief description of the sample: Concrete Test Sample
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Precast Unlimited Inc.
The concrete mix design number: CT850SLA50
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 115836
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: BACK OF THE TRUCK
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2026-06-22-6-1
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Verified Date: 06/22/2026
Date Tested: 06/22/2026
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: 2026-06-22-6-2
Test Method: ASTM C138-17a: Standard Test Method for Density (Unit Weight), Yield, and Air Content (Gravimetric) of Concrete
Verified Date: 06/22/2026
Date Tested: 06/22/2026
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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115836
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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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145 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: 2026-06-22-6-3
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 06/22/2026
Date Tested: 06/22/2026
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: 2026-06-22-6-4
Test Method: ASTM C231-17a: Standard Test Method for Air Content of Freshly Mixed Concrete by the Pressure Method
Verified Date: 06/22/2026
Date Tested: 06/22/2026
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: 2026-06-22-6-5
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Verified Date: 07/07/2026
Date Tested: 07/06/2026
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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Unit system used?
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US Units
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Number of specimens
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3
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Test performed
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With no density determined
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Capped in accordance with?
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ASTM C617 - Sulfur Mortar Cap
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Apparent mass of submerged cylinder 1
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8.5 lb
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Average diameter of cylinder 1
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4.00 in
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Average diameter of cylinder 2
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4.00 in
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Average diameter of cylinder 3
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4.00 in
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Cross sectional area of cylinder 1
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12.56 in^2
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Cross sectional area of cylinder 2
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12.56 in^2
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Cross sectional area of cylinder 3
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12.56 in^2
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Compressive strength (to nearest 10 psi)
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5830 psi
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Maximum load on cylinder 1
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70720 lb
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Maximum load on cylinder 2
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75460 lb
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Maximum load on cylinder 3
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73510 lb
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Type of fracture pattern of cylinder 1
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2
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Type of fracture pattern of cylinder 2
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3
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Type of fracture pattern of cylinder 3
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3
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Comment on any defect in either specimen or caps (Max 250 Characters)
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no data
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Correction factor for cylinder 1
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1
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Correction factor for cylinder 2
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1
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Correction factor for cylinder 3
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1
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Age of specimen
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14 days
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Age of specimen in hours
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no data0 hours
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Serial number of delivery ticket, if available
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no data
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