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Sample Record for 2023-01-04-18

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

Project Information

Project ID: 99999 DEA: 0322222 QA Service Level:
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2023-01-04-18
TL Number from the TL Form:
Sample Submitted By Organization: CT D01 - District 1 Materials Laboratory
Sample Organization Contact: (707) 496-0974
Type of Sample: Verification
Type of Material: Concrete
Sample Taken Date: 01/04/2023
Date that the sample was received by the laboratory/organization performing the testing: 01/03/2023
The quantity of what the sample constitutes: 70 CY
A brief description of the sample: Portland Cement Concrete
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Mercer Fraser - Fortuna

Material Information

The concrete mix design number: MFCL2SLAG
The truck number from where the sample was collected: 694
The batch plant ticket number from where the sample was collected: 027675
Concrete batch plant: Mercer Fraser Fortuna
The fabricator/manufacturer designation for the sample: MFCL2SLAG
A detailed description of where the material sample was collected: Chute
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test results on following page(s): 5

Test Results

Test 1 of 5

DIME Test ID: 2023-01-04-18-1
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1726 Albee Street,RSP #1
Organization City: Eureka
Organization State: CA
Organization Zipcode: 95501
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
This test has been superseded on 01/13/2023. The corrected test ID is: 2023-01-04-18-5
Reason: corrected

Test 2 of 5

DIME Test ID: 2023-01-04-18-2
Test Method: CTM 504-June 2010: Method of Test for Determining Air Content of Freshly Mixed Concrete by the Pressure Method
Verified Date: 01/13/2023
Date Tested: 01/13/2023
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1726 Albee Street,
Organization City: Eureka
Organization State: CA
Organization Zipcode: 95501
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Air Content 1.2 %

Test 3 of 5

DIME Test ID: 2023-01-04-18-4
Test Method: CTM 518-June 2010: Method of Test for Unit Weight of Fresh Concrete
Verified Date: 01/13/2023
Date Tested: 01/13/2023
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1726 Albee Street,
Organization City: Eureka
Organization State: CA
Organization Zipcode: 95501
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Unit weight of the concrete 145 lb/ft^3
Cement content 750 lb/yd^3

Test 4 of 5

DIME Test ID: 2023-01-04-18-5
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1726 Albee Street,
Organization City: Eureka
Organization State: CA
Organization Zipcode: 95501
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
Data has not been verified.

Test 5 of 5

DIME Test ID: 2023-01-04-18-6
Test Method: CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 02/07/2023
Date Tested: 02/06/2023
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1726 Albee Street,
Organization City: Eureka
Organization State: CA
Organization Zipcode: 95501
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
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
Capped in accordance with? ASTM C617 - Sulfur Mortar Cap
Average diameter of cylinder 1 6.00 in
Average diameter of cylinder 2 6.00 in
Cross sectional area of cylinder 1 28.3 in^2
Cross sectional area of cylinder 2 28.3 in^2
Compressive strength (to nearest 10 psi) 4000 psi
Maximum load on cylinder 1 200000 lb
Maximum load on cylinder 2 20000 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 32 days
Age of specimen in hours 0 hours