Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994248 DEA: 051K1204 EFIS: 0518000125
QA Service Level: 1
DIST-CO-RTE-PM: 05-SCR-9-1.0,4.0
Work Description: CONSTRUCT SIDEHILL VIADUCTS.
Location Description: SANTA CRUZ COUNTY AT 0.5 MILE NORTH OF VERNON STREET AND AT 0.8 MILE SOUTH OF GLENGARRY ROAD
Contractor Name: GORDON N BALL INC
Contractor Address: 333 CAMILLE AVENUE, ALAMO, CA 94507
Resident Engineer: Farshad Keshavarzi Structure Rep.: James Wilcenski
DIME Sample ID: 2023-05-07-27
TL Number from the TL Form:
Sample Submitted By Organization: RMA Group - Rancho Cordova
Sample Organization Contact: (916) 631-7194
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 05/07/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/07/2023
The quantity of what the sample constitutes: 100 cy
A brief description of the sample: Concrete
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Rock
The concrete mix design number: 57S750
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 420919
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Concrete truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2023-05-07-27-1
Test Method: CTM 557-June 2020: Method of Test for Temperature of Freshly Mixed Hydraulic Cement Concrete
Verified Date: 07/12/2023
Date Tested: 05/07/2023
Submitted By Organization: RMA Group - Rancho Cordova
Organization Address: 3150 Fitzgerald Road,
Organization City: Rancho Cordova
Organization State: CA
Organization Zipcode: 95742
Organization Email: mlowrance@rmacompanies.com
Organization Phone: (916) 631-7194
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
DIME Test ID: 2023-05-07-27-2
Test Method: CTM 504-June 2010: Method of Test for Determining Air Content of Freshly Mixed Concrete by the Pressure Method
Verified Date: 07/12/2023
Date Tested: 05/07/2023
Submitted By Organization: RMA Group - Rancho Cordova
Organization Address: 3150 Fitzgerald Road,
Organization City: Rancho Cordova
Organization State: CA
Organization Zipcode: 95742
Organization Email: mlowrance@rmacompanies.com
Organization Phone: (916) 631-7194
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
DIME Test ID: 2023-05-07-27-3
Test Method: ASTM C143-15a: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 07/12/2023
Date Tested: 05/07/2023
Submitted By Organization: RMA Group - Rancho Cordova
Organization Address: 3150 Fitzgerald Road,
Organization City: Rancho Cordova
Organization State: CA
Organization Zipcode: 95742
Organization Email: mlowrance@rmacompanies.com
Organization Phone: (916) 631-7194
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
DIME Test ID: 2023-05-07-27-4
Test Method: CTM 518-June 2010: Method of Test for Unit Weight of Fresh Concrete
Verified Date: 07/12/2023
Date Tested: 05/07/2023
Submitted By Organization: RMA Group - Rancho Cordova
Organization Address: 3150 Fitzgerald Road,
Organization City: Rancho Cordova
Organization State: CA
Organization Zipcode: 95742
Organization Email: mlowrance@rmacompanies.com
Organization Phone: (916) 631-7194
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Unit weight of the concrete
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125.61 lb/ft^3
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Cement content
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0 lb/yd^3
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