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Sample Record for 2021-06-28-3

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 215424 DEA: 024G4404 EFIS: 0214000013 QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-3-38.0/38.6
Work Description: BRIDGE REPLACEMENT
Location Description: SISKIYOU COUNTY ABOUT 6 MILES NORTH OF FORT JONES FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF LOWER MOFFETT CREEK ROAD
Contractor Name: Steelhead Constructors
Contractor Address: 2940 INNSBRUCK DRIVE, REDDING CA 96003
Resident Engineer: Nicole Mallory Structure Rep.: Andy O'Sullivan

Sample Information

DIME Sample ID: 2021-06-28-3
TL Number from the TL Form:
Sample Submitted By Organization: Con-Fab California Corporation - Lathrop
Sample Organization Contact: 209-249-4700
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 06/28/2021
Date that the sample was received by the laboratory/organization performing the testing: 06/29/2021
The quantity of what the sample constitutes: 24.25 CY
A brief description of the sample: Concrete 6 x 12 Cylinders
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: ConFab California, LLC

Material Information

The concrete mix design number: 98LV25AF
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 3416
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Bed 1B, 3rd Truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 3

DIME Test ID: 2021-06-28-3-1
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 09/22/2021
Date Tested: 06/28/2021
Submitted By Organization: Con-Fab California Corporation - Lathrop
Organization Address: 1910 E. Lathrop Rd.,
Organization City: Lathrop
Organization State: CA
Organization Zipcode: 95330
Organization Email:
Organization Phone: 209-249-4700
General Comments for this Test: Slump Flow = 24.5"
Test Result Compliance:
Additional Comments When Verified:
Slump 24.5 inch

Test 2 of 3

DIME Test ID: 2021-06-28-3-2
Test Method: ASTM C138-17a: Standard Test Method for Density (Unit Weight), Yield, and Air Content (Gravimetric) of Concrete
Verified Date: 09/22/2021
Date Tested: 06/28/2021
Submitted By Organization: Con-Fab California Corporation - Lathrop
Organization Address: 1910 E. Lathrop Rd.,
Organization City: Lathrop
Organization State: CA
Organization Zipcode: 95330
Organization Email:
Organization Phone: 209-249-4700
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Identification of concrete represented by the sample Middle of Third Truck
Volume of the measure 0.25 ft^3
Density of concrete 142 lb/ft^3
Yield of concrete 6.38 yd^3
Relative yield of the batch 1.02
Cement content 0.268 lb/yd^3
Air content 7 %

Test 3 of 3

DIME Test ID: 2021-06-28-3-3
Test Method: ASTM C231-17a: Standard Test Method for Air Content of Freshly Mixed Concrete by the Pressure Method
Verified Date: 09/22/2021
Date Tested: 06/28/2021
Submitted By Organization: Con-Fab California Corporation - Lathrop
Organization Address: 1910 E. Lathrop Rd.,
Organization City: Lathrop
Organization State: CA
Organization Zipcode: 95330
Organization Email:
Organization Phone: 209-249-4700
General Comments for this Test: 7% Air Content
Test Result Compliance:
Additional Comments When Verified:
Air content 7 %

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.