Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001123 DEA: 051H4704 EFIS: 0516000078
QA Service Level: 1
DIST-CO-RTE-PM: 05-SCR-9-9-13.6,15.5
Work Description: REPLACE BRIDGES AND INSTALL MGS.
Location Description: SANTA CRUZ COUNTY NEAR BOULDER CREEK AT SAN LORENZO RIVER BRIDGE AND AT KINGS CREEK BRIDGE
Contractor Name: GORDON N. BALL, INC.
Contractor Address: Unknown
Resident Engineer: Ian Nguyen Structure Rep.: Jarred Burrows
DIME Sample ID: 2026-06-25-77
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Vallejo Field Laboratory
Sample Organization Contact: 9166394315
Type of Sample: Quality Assurance
Type of Material: Precast Concrete
Sample Taken Date: 06/25/2026
Date that the sample was received by the laboratory/organization performing the testing: 06/25/2026
The quantity of what the sample constitutes: 42 CY
A brief description of the sample: 4x8 Concrete Test Samples
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Kie-Con Antioch
The concrete mix design number: K25-087BG
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 127638
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: wheelbarrow
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2026-06-25-77-1
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Verified Date: 07/23/2026
Date Tested: 07/23/2026
Submitted By Organization: CT HQ - Vallejo Field Laboratory
Organization Address: 690 Walnut,
Organization City: vallejo
Organization State: CA
Organization Zipcode: 94592
Organization Email: yannick.aranas@dot.ca.gov
Organization Phone: (916) 639-4315
General Comments for this Test: All cylinder has pocket holes on the side and cylinder number 3 broke below strength
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 C39 - Ground End
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Apparent mass of submerged cylinder 1
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9 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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12.57 in^2
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Cross sectional area of cylinder 2
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12.57 in^2
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Cross sectional area of cylinder 3
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12.57 in^2
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Compressive strength (to nearest 10 psi)
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7970 psi
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Maximum load on cylinder 1
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106840 lb
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Maximum load on cylinder 2
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105075 lb
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Maximum load on cylinder 3
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88780 lb
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Compressive strength of cylinder 1
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8500.0 psi
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Type of fracture pattern of cylinder 1
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3
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Compressive strength of cylinder 2
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8360.0 psi
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Compressive strength of cylinder 3
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7060 psi
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Type of fracture pattern of cylinder 2
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4
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Type of fracture pattern of cylinder 3
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4
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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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no data0 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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