Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215710 DEA: 051N3504 EFIS: 0520000173
QA Service Level: 1
DIST-CO-RTE-PM: 05-SLO-101-37.8/46.0, 37.0/46.0
Work Description: Replace concrete pavement with precast concrete panels.
Location Description: Near Atascadero on US 101 from 0.1 mile south of Route 58/10 separation to Traffic Way.
Contractor Name: FBD VANGUARD CONSTRUCTION, INC.
Contractor Address: 550 Greenville Road, Livermore, CA 94550
Resident Engineer: Dean Russu Structure Rep.: Unknown
DIME Sample ID: 2022-01-24-53
TL Number from the TL Form:
Sample Submitted By Organization: Pro-Cast Products, Incorporated - Highland
Sample Organization Contact: (909) 793-7602
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 01/24/2022
Date that the sample was received by the laboratory/organization performing the testing: 01/25/2022
The quantity of what the sample constitutes: 8
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: ProCast Products
The concrete mix design number: RRM14062
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: TT
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Concrete from wheelbarrow
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2022-01-24-53-1
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Submitted By Organization: Pro-Cast Products, Incorporated - Highland
Organization Address: 27417 East Third Street, P.O. Box 602
Organization City: Highland
Organization State: CA
Organization Zipcode: 92346
Organization Email: miker@procast.us
Organization Phone: (909) 557-3336
Data has not been verified.
DIME Test ID: 2022-01-24-53-2
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Submitted By Organization: Pro-Cast Products, Incorporated - Highland
Organization Address: 27417 East Third Street, P.O. Box 602
Organization City: Highland
Organization State: CA
Organization Zipcode: 92346
Organization Email: miker@procast.us
Organization Phone: (909) 557-3336
Data has not been verified.
DIME Test ID: 2022-01-24-53-3
Test Method: ASTM C39-18: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Submitted By Organization: Pro-Cast Products, Incorporated - Highland
Organization Address: 27417 East Third Street, P.O. Box 602
Organization City: Highland
Organization State: CA
Organization Zipcode: 92346
Organization Email: miker@procast.us
Organization Phone: (909) 557-3336
Data has not been verified.
