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Sample Record for 2021-09-15-37

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Project Information

Project ID: 214114 DEA: 040A5394 EFIS: 0418000244 QA Service Level: 1
DIST-CO-RTE-PM: 04-SOL-80,12-11.4/12.8, 2.1/2.8
Work Description: Widen EB SR-12 Connector, Construct 3 ramps & 2 box girder bridges, remove existing bridge, etc.
Location Description: I-80/I-680/Route 12 Interchange
Contractor Name: Kiewit Infrastructure West Co.
Contractor Address: 4650 Business Center Drive, Fairfield, CA 94534
Resident Engineer: Fernando Dos Santos Structure Rep.: Alejandro Lara

Sample Information

DIME Sample ID: 2021-09-15-37
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: 09/15/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/15/2021
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: Syar

Material Information

The concrete mix design number: CT063AC5
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 82837447
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: 1-80 WB under the Lopes Rd overpass
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 4

DIME Test ID: 2021-09-15-37-1
Test Method: CTM 557-June 2020: Method of Test for Temperature of Freshly Mixed Hydraulic Cement Concrete
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
Data has not been verified.

Test 2 of 4

DIME Test ID: 2021-09-15-37-2
Test Method: CTM 504-June 2010: Method of Test for Determining Air Content of Freshly Mixed Concrete by the Pressure Method
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
Data has not been verified.

Test 3 of 4

DIME Test ID: 2021-09-15-37-3
Test Method: CTM 518-June 2010: Method of Test for Unit Weight of Fresh Concrete
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
Data has not been verified.

Test 4 of 4

DIME Test ID: 2021-09-15-37-4
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
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
Data has not been verified.

Tests Assigned to this Sample

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