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Sample Record for 2021-09-24-32

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

Project Information

Project ID: 215486 DEA: 040A0204 EFIS: 0400000129 QA Service Level: 1
DIST-CO-RTE-PM: 04-SON-1-15-15.7
Work Description: CONSTRUCTION ON STATE HIGHWAY IN SONOMA COUNTY NEAR BODEGA BAY FROM 0.2 MILE SOUTH TO 0.4 MILE NORTH OF SCOTTY CREEK CULVERT.
Location Description:
Contractor Name: BRIDGEWAY CIVIL CONSTRUCTORS, INC.
Contractor Address: 4950 Allison Parkway, # A, Vacaville, CA 95688
Resident Engineer: Syd Valeh Structure Rep.: Bunma Nou

Sample Information

DIME Sample ID: 2021-09-24-32
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: 09/24/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/24/2021
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: Shamrock Concrete

Material Information

The concrete mix design number: SL-4700
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 413829
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: CIDH Pile
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: 2021-09-24-32-1
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: 2021-09-24-32-2
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: 2021-09-24-32-3
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: 2021-09-24-32-4
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.