Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214841 DEA: 034H1004 EFIS: 0318000176
QA Service Level: 1
DIST-CO-RTE-PM: 03-SIE-49-9.2/24.7
Work Description: INSTALL RETAINING STRUCTURE AND RSP CONCRETE EMBANKMENT.
Location Description: SIERRA COUNTY ON ROUTE 49 AT VARIOUS LOCATIONS
Contractor Name: GORDON N BALL INC
Contractor Address: 333 CAMILLE AVENUE, ALAMO CA 94507
Resident Engineer: Christopher Fallbeck Structure Rep.: Jimmer Ross
DIME Sample ID: 2020-07-17-31
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: 07/17/2020
Date that the sample was received by the laboratory/organization performing the testing: 07/17/2020
The quantity of what the sample constitutes: 24 CY
A brief description of the sample: PCC
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Hansen Bros Enterprises
The concrete mix design number: 7825P-WNA
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 5191043
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Truck No 218
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2020-07-17-31-1
Test Method: CTM 557-June 2020: Method of Test for Temperature of Freshly Mixed Hydraulic Cement Concrete
Verified Date: 04/13/2022
Date Tested: 07/17/2020
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: 2020-07-17-31-2
Test Method: ASTM C143-15a: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 04/13/2022
Date Tested: 07/17/2020
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: 2020-07-17-31-3
Test Method: CTM 504-June 2010: Method of Test for Determining Air Content of Freshly Mixed Concrete by the Pressure Method
Verified Date: 04/13/2022
Date Tested: 07/17/2020
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:
