Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001910 DEA: 044X5304 EFIS: 0426000087 COOP: NONE
QA Service Level: 1
DIST-CO-RTE-PM: 04-NAP-29-23.54/23.54
Work Description: REMOVE AND EXISTING CULVERT AND REPLACE WITH CAST IN PLACE BOX CULVERT AND REPAIR ROADWAY REPLACE CULVERT AND REPAIR ROADWAY
Location Description: IN NAPA CO. HWY 29 PM 23.54
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Nestor A 'Angelo' Perez Jr
DIME Sample ID: 2026-04-16-85
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: 04/16/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/17/2026
The quantity of what the sample constitutes: 9
A brief description of the sample: 4x8 Cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 475115E1 Set 1
Structure unique identifier:
Structure name: S/B RTE 29 Wing Wall Trck 2460
The fabricator/manufacturer/facility name: Shamrock Materials
The concrete mix design number: 475115E1
The truck number from where the sample was collected: Load 1
The batch plant ticket number from where the sample was collected: 0
Concrete batch plant: Shamrock Materials
The fabricator/manufacturer designation for the sample: Set 1
A detailed description of where the material sample was collected: S/B RTE 29 Wing Wall
Where the material sample would have been placed if not sampled:
From Lot No.: 1
Bag Lot No.: 1
DIME Test ID: 2026-04-16-85-1
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.
DIME Test ID: 2026-04-16-85-2
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: 2026-04-16-85-3
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: 2026-04-16-85-4
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: 2026-04-16-85-5
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
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: 2026-04-16-85-6
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
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: 2026-04-16-85-7
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
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.
