Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215231 DEA: 042A3324 EFIS: 0414000039
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-84-10.8/18
Work Description: NILES CANYON SAFETY PROJECT
Location Description: ALAMEDA CREEK BR OH (33-0034) BRIDGE RAIL REPLACEMENT, 2,060 LF; AND STONYBROOK CREEK BRIDGE (SLAB BRIDGE)
Contractor Name: Bay Cities Paving & Grading
Contractor Address: 1450 Civic Ct. BLDG B #400, Concord CA, 94520
Resident Engineer: Eddie Dike Structure Rep.: Oanh Bui
DIME Sample ID: 2022-05-11-63
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: 05/11/2022
Date that the sample was received by the laboratory/organization performing the testing: 05/11/2022
The quantity of what the sample constitutes: 1 Day
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: Central
The concrete mix design number: C80CC5T2
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 121199
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Alameda Creek Bridge Abutment 1 to Bent 9 Westbound Overhang
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2022-05-11-63-1
Test Method: CTM 557-June 2020: Method of Test for Temperature of Freshly Mixed Hydraulic Cement Concrete
Verified Date: 07/05/2022
Date Tested: 05/11/2022
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
DIME Test ID: 2022-05-11-63-2
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 07/05/2022
Date Tested: 05/11/2022
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
