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Sample Record for 2021-09-21-44

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

Project Information

Project ID: 213099 DEA: 041A6614 EFIS: 0415000291 COOP: 042683A1 QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN-101-8.4
Work Description: CONSTRUCTION ON STATE HIGHWAY IN MARIN COUNTY IN LARKSPUR
Location Description:
Contractor Name: Disney Construction
Contractor Address: 533 airport Blvd, Suite 120, Burlingame, CA 94010
Resident Engineer: Steven Russell Structure Rep.: Long Ly

Sample Information

DIME Sample ID: 2021-09-21-44
TL Number from the TL Form:
Sample Submitted By Organization: Kie-Con, Incorporated - Antioch
Sample Organization Contact: (925) 331-7122
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 09/21/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/22/2021
The quantity of what the sample constitutes: 17 Cubic Yards
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: KIE-CON, INC

Material Information

The concrete mix design number: K5670-500 CP R2
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 112088
Concrete batch plant:
The fabricator/manufacturer designation for the sample: 20-088C 9/21/2021
A detailed description of where the material sample was collected: Concrete sample from wheelbarrow
Where the material sample would have been placed if not sampled: L Beam
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 5

DIME Test ID: 2021-09-21-44-1
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Verified Date: 10/04/2021
Date Tested: 09/21/2021
Submitted By Organization: Kie-Con, Incorporated - Antioch
Organization Address: 3551 Wilbur Avenue,
Organization City: Antioch
Organization State: CA
Organization Zipcode: 94509
Organization Email: gregory.lask@kiewit.com
Organization Phone: (925) 331-7122
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Temperature 81 F

Test 2 of 5

DIME Test ID: 2021-09-21-44-2
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 10/04/2021
Date Tested: 09/21/2021
Submitted By Organization: Kie-Con, Incorporated - Antioch
Organization Address: 3551 Wilbur Avenue,
Organization City: Antioch
Organization State: CA
Organization Zipcode: 94509
Organization Email: gregory.lask@kiewit.com
Organization Phone: (925) 331-7122
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Slump 9.25 inch

Test 3 of 5

DIME Test ID: 2021-09-21-44-3
Test Method: ASTM C138-17a: Standard Test Method for Density (Unit Weight), Yield, and Air Content (Gravimetric) of Concrete
Verified Date: 10/04/2021
Date Tested: 09/21/2021
Submitted By Organization: Kie-Con, Incorporated - Antioch
Organization Address: 3551 Wilbur Avenue,
Organization City: Antioch
Organization State: CA
Organization Zipcode: 94509
Organization Email: gregory.lask@kiewit.com
Organization Phone: (925) 331-7122
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Identification of concrete represented by the sample 112088
Volume of the measure 0.25 ft^3
Density of concrete 148.8 lb/ft^3
Yield of concrete no data
Relative yield of the batch no data
Cement content no data
Air content no data

Test 4 of 5

DIME Test ID: 2021-09-21-44-4
Test Method: ASTM C39-18: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Verified Date: 10/04/2021
Date Tested: 09/22/2021
Submitted By Organization: Kie-Con, Incorporated - Antioch
Organization Address: 3551 Wilbur Avenue,
Organization City: Antioch
Organization State: CA
Organization Zipcode: 94509
Organization Email: gregory.lask@kiewit.com
Organization Phone: (925) 331-7122
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Unit system used? US Units
Number of specimens 2
Test performed With no density determined
Average diameter of cylinder 1 6.00 in
Average diameter of cylinder 2 6.00 in
Capped in accordance with? ASTM C617 - Sulfur Mortar Cap
Cross sectional area of cylinder 1 28.27 in^2
Cross sectional area of cylinder 2 28.27 in^2
Compressive strength (to nearest 10 psi) 5120 psi
Maximum load on cylinder 1 145630 lb
Maximum load on cylinder 2 143900 lb
Type of fracture pattern of cylinder 1 1
Type of fracture pattern of cylinder 2 1
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Correction factor for cylinder 2 1
Age of specimen 1 days
Age of specimen in hours 19 hours

Test 5 of 5

DIME Test ID: 2021-09-21-44-5
Test Method: ASTM C39-18: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Verified Date: 10/04/2021
Date Tested: 10/01/2021
Submitted By Organization: Kie-Con, Incorporated - Antioch
Organization Address: 3551 Wilbur Avenue,
Organization City: Antioch
Organization State: CA
Organization Zipcode: 94509
Organization Email: gregory.lask@kiewit.com
Organization Phone: (925) 331-7122
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Unit system used? US Units
Number of specimens 2
Test performed With no density determined
Average diameter of cylinder 1 6.00 in
Average diameter of cylinder 2 6.00 in
Capped in accordance with? ASTM C617 - Sulfur Mortar Cap
Cross sectional area of cylinder 1 28.27 in^2
Cross sectional area of cylinder 2 28.27 in^2
Compressive strength (to nearest 10 psi) 8290 psi
Maximum load on cylinder 1 231120 lb
Maximum load on cylinder 2 237500 lb
Type of fracture pattern of cylinder 1 1
Type of fracture pattern of cylinder 2 1
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1
Correction factor for cylinder 2 1
Age of specimen 10 days
Age of specimen in hours 0 hours