Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000121 DEA: 041Q8204 EFIS: 0418000341
QA Service Level: 1
DIST-CO-RTE-PM: 04-SF-101-25.6/26.1
Work Description: SF 101-Roadway Rehab 3R
Location Description: Route 101 in San Francisco County
Contractor Name: FBD VANGUARD CONSTRUCTION, INC.
Contractor Address: 550 Greenville Road, Livermore, CA 94550
Resident Engineer: Tom Robinson Structure Rep.: ABBAS Iranmanesh
DIME Sample ID: 2026-09-05-6
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Petaluma Field Laboratory
Sample Organization Contact: 510-385-7413
Type of Sample: Acceptance
Type of Material: Concrete
Sample Taken Date: 09/05/2026
Date that the sample was received by the laboratory/organization performing the testing: 09/07/2026
The quantity of what the sample constitutes: 900 cy
A brief description of the sample: Cylinders
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Cemex 500
The concrete mix design number: HE4X20BM
The truck number from where the sample was collected: 6144
The batch plant ticket number from where the sample was collected: 32130860
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Discharge from concrete truck into wheelbarrow.
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2026-09-05-6-1
Test Method: ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Verified Date: 09/15/2026
Date Tested: 09/15/2026
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:
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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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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7270 psi
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Maximum load on cylinder 1
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92210 lb
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Maximum load on cylinder 2
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92200 lb
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Maximum load on cylinder 3
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89745 lb
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Compressive strength of cylinder 1
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7335.7 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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7334.9 psi
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Compressive strength of cylinder 3
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7139.6 psi
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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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5
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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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10 days
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Age of specimen in hours
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no data
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