Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994751 DEA: 010C5004 EFIS: 0112000292
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-36-11.3/34.6
Work Description: Project Name: Bridge Rail Replacement - 3 Bridges
Location Description: Hely Creek, Little Larabee Creek and Butte Creek Bridge.
Contractor Name: Mercer-Fraser Company
Contractor Address: 200 Dinsmore Dr, Fortuna, CA 95540
Resident Engineer: Joseph Lasensky Structure Rep.: Adlai Evans
DIME Sample ID: 2026-09-16-28
TL Number from the TL Form:
Sample Submitted By Organization: CT D01 - Boyd Road Field Laboratory
Sample Organization Contact: (707) 496-0974
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 09/16/2026
Date that the sample was received by the laboratory/organization performing the testing: 09/17/2026
The quantity of what the sample constitutes: 85 CY
A brief description of the sample: Type II/V cement
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name: Butte Creek Bridge
The fabricator/manufacturer/facility name: Mercer Fraser - Fortuna
The concrete mix design number: CTBDS.40 AE
The truck number from where the sample was collected: 697
The batch plant ticket number from where the sample was collected: 115969
Concrete batch plant: Mercer Fraser Fontana
The fabricator/manufacturer designation for the sample: Mercer Fraser
A detailed description of where the material sample was collected: From the chute
Where the material sample would have been placed if not sampled: Stage 1 Deck
From Lot No.:
Bag Lot No.:
DIME Test ID: 2026-09-16-28-1
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 09/23/2026
Date Tested: 09/23/2026
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1050 River Ranch Road,
Organization City: Fortuna
Organization State: California
Organization Zipcode: 95540
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
|
Unit system used?
|
US Units
|
|
Number of specimens
|
3
|
|
Test performed
|
With no density determined
|
|
Capped in accordance with?
|
ASTM C1231 - Unbonded Elastomeric Pad Cap
|
|
Average diameter of cylinder 1
|
4.00 in
|
|
Average diameter of cylinder 2
|
4.00 in
|
|
Average diameter of cylinder 3
|
4.00 in
|
|
Cross sectional area of cylinder 1
|
12.57 in^2
|
|
Cross sectional area of cylinder 2
|
12.57 in^2
|
|
Cross sectional area of cylinder 3
|
12.57 in^2
|
|
Compressive strength (to nearest 10 psi)
|
3820 psi
|
|
Maximum load on cylinder 1
|
46795 lb
|
|
Maximum load on cylinder 2
|
48750 lb
|
|
Maximum load on cylinder 3
|
48405 lb
|
|
Type of fracture pattern of cylinder 1
|
3
|
|
Type of fracture pattern of cylinder 2
|
3
|
|
Type of fracture pattern of cylinder 3
|
3
|
|
Comment on any defect in either specimen or caps (Max 250 Characters)
|
no data
|
|
Correction factor for cylinder 1
|
1
|
|
Correction factor for cylinder 2
|
1
|
|
Correction factor for cylinder 3
|
1
|
|
Age of specimen
|
7 days
|
|
Age of specimen in hours
|
no data0 hours
|
DIME Test ID: 2026-09-16-28-2
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 09/25/2026
Date Tested: 09/25/2026
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1050 River Ranch Road,
Organization City: Fortuna
Organization State: California
Organization Zipcode: 95540
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
General Comments for this Test: 9/25/26 9 Day Break
Test Result Compliance:
Additional Comments When Verified:
|
Unit system used?
|
US Units
|
|
Number of specimens
|
3
|
|
Test performed
|
With no density determined
|
|
Capped in accordance with?
|
ASTM C1231 - Unbonded Elastomeric Pad Cap
|
|
Average diameter of cylinder 1
|
4.00 in
|
|
Average diameter of cylinder 2
|
4.00 in
|
|
Average diameter of cylinder 3
|
4.00 in
|
|
Cross sectional area of cylinder 1
|
12.57 in^2
|
|
Cross sectional area of cylinder 2
|
12.57 in^2
|
|
Cross sectional area of cylinder 3
|
12.57 in^2
|
|
Compressive strength (to nearest 10 psi)
|
4140 psi
|
|
Maximum load on cylinder 1
|
50926 lb
|
|
Maximum load on cylinder 2
|
54316 lb
|
|
Maximum load on cylinder 3
|
51087 lb
|
|
Type of fracture pattern of cylinder 1
|
2
|
|
Type of fracture pattern of cylinder 2
|
3
|
|
Type of fracture pattern of cylinder 3
|
3
|
|
Comment on any defect in either specimen or caps (Max 250 Characters)
|
no data
|
|
Correction factor for cylinder 1
|
1
|
|
Correction factor for cylinder 2
|
1
|
|
Correction factor for cylinder 3
|
1
|
|
Age of specimen
|
9 days
|
|
Age of specimen in hours
|
no data0 hours
|
DIME Test ID: 2026-09-16-28-3
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 10/14/2026
Date Tested: 10/14/2026
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1050 River Ranch Road,
Organization City: Fortuna
Organization State: California
Organization Zipcode: 95540
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
General Comments for this Test: 10/14/26 28 Day Break
Test Result Compliance:
Additional Comments When Verified:
|
Unit system used?
|
US Units
|
|
Number of specimens
|
3
|
|
Test performed
|
With no density determined
|
|
Capped in accordance with?
|
ASTM C1231 - Unbonded Elastomeric Pad Cap
|
|
Average diameter of cylinder 1
|
4.00 in
|
|
Average diameter of cylinder 2
|
4.00 in
|
|
Average diameter of cylinder 3
|
4.00 in
|
|
Cross sectional area of cylinder 1
|
12.57 in^2
|
|
Cross sectional area of cylinder 2
|
12.57 in^2
|
|
Cross sectional area of cylinder 3
|
12.57 in^2
|
|
Compressive strength (to nearest 10 psi)
|
7200 psi
|
|
Maximum load on cylinder 1
|
92317 lb
|
|
Maximum load on cylinder 2
|
91966 lb
|
|
Maximum load on cylinder 3
|
87269 lb
|
|
Type of fracture pattern of cylinder 1
|
3
|
|
Type of fracture pattern of cylinder 2
|
3
|
|
Type of fracture pattern of cylinder 3
|
3
|
|
Comment on any defect in either specimen or caps (Max 250 Characters)
|
no data
|
|
Correction factor for cylinder 1
|
1
|
|
Correction factor for cylinder 2
|
1
|
|
Correction factor for cylinder 3
|
1
|
|
Age of specimen
|
28 days
|
|
Age of specimen in hours
|
no data0 hours
|
