Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001194 DEA: 051H4404 EFIS: 0516000074
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB,SLO-1-50.3/50.6,0.0/0.3
Work Description: SANTA MARIA RIVER BRIDGE (REPLACE).
Location Description: SANTA BARBARA AND SAN LUIS OBISPO COUNTIES IN AND NEAR GUADALUPE AT SANTA MARIA RIVER BRIDGE
Contractor Name: M.C.M. CONSTRUCTION, INC.
Contractor Address: 6413 32nd Street, North Highlands, Ca 95660
Resident Engineer: Jacob Cooper Structure Rep.: Sal Heredia
DIME Sample ID: 2026-06-25-102
TL Number from the TL Form:
Sample Submitted By Organization: Pinnacle Prestress, Incorporated
Sample Organization Contact: 6616431412
Type of Sample: Quality Control
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: Concrete in wheelbarrow
A brief description of the sample: Precast Girder
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pinnacle Prestress, Inc.
The concrete mix design number: CON-NFA-9.00-FC8K- HALFINCH
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 354
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Concrete Sample from Wheelbarrow
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2026-06-25-102-1
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Submitted By Organization: Pinnacle Prestress, Incorporated
Organization Address: 425 J Street,
Organization City: Bakersfield
Organization State: CA
Organization Zipcode: 93820
Organization Email: carlos.coreas@kiewit.com
Organization Phone: (661) 643-1412
Data has not been verified.
