Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000403 DEA: 120K91U4 EFIS: 1222000031
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-91-R9.2/R11.4
Work Description: CONST BRIDGES, RW, SW, PAVEMENT, DRAINAGE AND ELECTRICAL SYSTEMS.
Location Description: ORANGE COUNTY IN ANAHEIM FROM 0.9 MILE WEST TO 1.3 MILES EAST OF LAKEVIEW AVENUE OVERCROSSING
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 16700 Valley View Avenue Suite 300
Resident Engineer: Steve Kinaly Structure Rep.: Wei-Jen Lee
DIME Sample ID: 2026-06-26-28
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: 06/26/2026
Date that the sample was received by the laboratory/organization performing the testing: 06/27/2026
The quantity of what the sample constitutes: 6
A brief description of the sample: 4x8 cylinders
From where was the sample collected: Job Site
Laboratory sample identification: RRM18087 Set 1
Structure unique identifier:
Structure name: Overhead Sign, 60" CIDH Pile
The fabricator/manufacturer/facility name: Robertson's Ready Mix Anaheim
The concrete mix design number: RRM18087
The truck number from where the sample was collected: Load 1
The batch plant ticket number from where the sample was collected: 2136713
Concrete batch plant: Robertsons Ready Mix
The fabricator/manufacturer designation for the sample: Set 1
A detailed description of where the material sample was collected: Overhead Sign, 60" CIDH Pile
Where the material sample would have been placed if not sampled:
From Lot No.: 1
Bag Lot No.: 1
DIME Test ID: 2026-06-26-28-1
Test Method: CTM 518-June 2010: Method of Test for Unit Weight of Fresh Concrete
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
Data has not been verified.
DIME Test ID: 2026-06-26-28-2
Test Method: CTM 504-June 2010: Method of Test for Determining Air Content of Freshly Mixed Concrete by the Pressure Method
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
Data has not been verified.
DIME Test ID: 2026-06-26-28-3
Test Method: CTM 556-January 2018: Method of Test for Slump of Fresh Portland Cement Concrete
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
Data has not been verified.
DIME Test ID: 2026-06-26-28-4
Test Method: CTM 557-June 2020: Method of Test for Temperature of Freshly Mixed Hydraulic Cement Concrete
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
Data has not been verified.
