Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001985 DEA: 010L9904 EFIS: 0122000073
QA Service Level: 1
DIST-CO-RTE-PM: 01-DN-199-T0.6/0.8
Work Description: DN 199 Construct Roundabout
Location Description:
Contractor Name: S.T. Rhoades Construction
Contractor Address: 8780 Old Oregon Trail, Redding, CA 96001
Resident Engineer: Ryan Dunne Structure Rep.: Unknown
DIME Sample ID: 2026-09-23-4
TL Number from the TL Form:
Sample Submitted By Organization: CT D01 - Crescent City Field Laboratory
Sample Organization Contact: (707) 496-5581
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 09/23/2026
Date that the sample was received by the laboratory/organization performing the testing: 09/22/2026
The quantity of what the sample constitutes: 40 CY
A brief description of the sample: Concrete pavement at roundabout
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Tidewater
The concrete mix design number: TWC-CT675PAV
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: XXXX
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Back of Truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2026-09-23-4-1
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 10/09/2026
Date Tested: 10/21/2026
Submitted By Organization: CT D01 - Crescent City Field Laboratory
Organization Address: 1444 Parkway Dr.,
Organization City: Crescent City
Organization State: CA
Organization Zipcode: 95531
Organization Email: clayton.malmberg@dot.ca.gov
Organization Phone: (707) 496-5581
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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1
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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 C1231 - Unbonded Elastomeric Pad Cap
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Average diameter of cylinder 1
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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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Compressive strength of cylinder (to nearest 10 psi)
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4200 psi
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Maximum load on cylinder 1
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52748 lb
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Type of fracture pattern of cylinder 1
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2
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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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Age of specimen
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16 days
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Age of specimen in hours
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no data0 hours
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