Sample Record for 2024-07-17-21
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 995028 DEA: 010H4314 EFIS: 0117000214
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-299-R11.0/R11.4
Work Description: Project Name: Korbel Wall (Description of Work: CONSTRUCT RETAINING WALL, RECONSTRUCT ROADWAY, & REPLACE CULVERT)
Location Description: HUMBOLDT COUNTY ABOUT 6 MILES EAST OF BLUE LAKE FROM NORTH FORK MAD RIVER BRIDGE TO 0.4 MILE EAST OF NORTH FORK MAD RIVER BRIDGE
Contractor Name: MCCULLOUGH CONSTRUCTION INC
Contractor Address: 57 Aldergrove Road, Arcata, CA 95521
Resident Engineer: Brenda Howell Structure Rep.: Dustin Helliwell
Sample Information
DIME Sample ID: 2024-07-17-21
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 Control
Type of Material: Concrete
Sample Taken Date: 07/17/2024
Date that the sample was received by the laboratory/organization performing the testing: 07/18/2024
The quantity of what the sample constitutes: 54 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: 12-0E0058
Structure name: Korbel Wall
The fabricator/manufacturer/facility name: Eureka Ready mix
Material Information
The concrete mix design number: E400F
The truck number from where the sample was collected: 72
The batch plant ticket number from where the sample was collected: 36988
Concrete batch plant: Arcata Eureka Ready Mix
The fabricator/manufacturer designation for the sample: Batch
A detailed description of where the material sample was collected: Concrete Truck Chute
Where the material sample would have been placed if not sampled: Waler 2
From Lot No.:
Bag Lot No.:
Test Results
Test 1 of 2
DIME Test ID: 2024-07-17-21-4
Test Method: CTM 557-July 2012: Method of Test for Temperature of Freshly Mixed Portland Cement Concrete
Verified Date: 07/18/2024
Date Tested: 07/18/2024
Submitted By Organization: CT D01 - Boyd Road Field 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: 55
Test Result Compliance:
Additional Comments When Verified:
|
Temperature of the freshly mixed concrete
|
77 F
|
Test 2 of 2
DIME Test ID: 2024-07-17-21-9
Test Method: CTM 556-January 2018: Method of Test for Slump of Fresh Portland Cement Concrete
Verified Date: 07/18/2024
Date Tested: 07/17/2024
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:
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| 2024-07-17-21-1 | ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens | 07/18/2024 | Not scheduled | Dustin Helliwell | CT D01 - Boyd Road Field Laboratory | | Leif Ayres |
| 2024-07-17-21-2 | ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens | 07/18/2024 | Not scheduled | Dustin Helliwell | CT D01 - Boyd Road Field Laboratory | | Leif Ayres |
| 2024-07-17-21-3 | ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens | 07/18/2024 | Not scheduled | Dustin Helliwell | CT D01 - Boyd Road Field Laboratory | | Leif Ayres |
| 2024-07-17-21-5 | CTM 556-January 2018: Method of Test for Slump of Fresh Portland Cement Concrete | 07/18/2024 | Not scheduled | Dustin Helliwell | CT D01 - Boyd Road Field Laboratory | | |
| 2024-07-17-21-6 | CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders | 07/18/2024 | Not scheduled | Dustin Helliwell | CT D01 - District 1 Materials Laboratory | | |
| 2024-07-17-21-7 | CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders | 07/18/2024 | Not scheduled | Dustin Helliwell | CT D01 - District 1 Materials Laboratory | | |
| 2024-07-17-21-8 | CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders | 07/18/2024 | Not scheduled | Dustin Helliwell | CT D01 - District 1 Materials Laboratory | 28 Day Break 6/21/28 | |
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