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Sample Record for 2023-02-17-16

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Project Information

Project ID: 994486 DEA: 051Q0804 EFIS: 0522000148 QA Service Level: 1
DIST-CO-RTE-PM: 05-SCR,SCR/SCR-9,1-17.41/17.5
Work Description: Repair of viaduct barrier wall and replace CIDH piles. Holiday Lane Viaduct Slipout. State Route 9 at PM SCR-09-8.4 Jay's Slide, and SR 236 (SCR-236-16.87)
Location Description: Santa Cruz County. State Route 9 at PM SCR-09-8.4 and SR 236 (SCR-236-16.87)
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 580 West Beach St, Watsonville, CA 95076
Resident Engineer: Ian Nguyen Structure Rep.: Stephen Pozzo

Sample Information

DIME Sample ID: 2023-02-17-16
TL Number from the TL Form:
Sample Submitted By Organization: CT D05 - Monterey Construction Field Laboratory
Sample Organization Contact: 831-818-0254
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 02/17/2023
Date that the sample was received by the laboratory/organization performing the testing: 02/21/2023
The quantity of what the sample constitutes: 10 Cy
A brief description of the sample: CIDH Wet Hole PCC
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Las Animas Concrete

Material Information

The concrete mix design number: 713W25S
The truck number from where the sample was collected: 111
The batch plant ticket number from where the sample was collected: 366216
Concrete batch plant: Las Animas Concrete
The fabricator/manufacturer designation for the sample:
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:
From Lot No.:
Bag Lot No.:
Test results on following page(s): 4

Test Results

Test 1 of 4

DIME Test ID: 2023-02-17-16-3
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 03/17/2023
Date Tested: 02/17/2023
Submitted By Organization: CT D05 - Monterey Construction Field Laboratory
Organization Address: 1529 Salinas Highway,
Organization City: Monterey
Organization State: CA
Organization Zipcode: 93940
Organization Email: wesley.rider@dot.ca.gov
Organization Phone: (831) 818-0254
General Comments for this Test:
Test Result Compliance: does not comply
Additional Comments When Verified:
Slump 3 inch

Test 2 of 4

DIME Test ID: 2023-02-17-16-4
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Verified Date: 03/17/2023
Date Tested: 02/17/2023
Submitted By Organization: CT D05 - Monterey Construction Field Laboratory
Organization Address: 1529 Salinas Highway,
Organization City: Monterey
Organization State: CA
Organization Zipcode: 93940
Organization Email: wesley.rider@dot.ca.gov
Organization Phone: (831) 818-0254
General Comments for this Test:
Test Result Compliance: not applicable
Additional Comments When Verified:
Temperature 52 F

Test 3 of 4

DIME Test ID: 2023-02-17-16-5
Test Method: ASTM C143-10a: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 03/17/2023
Date Tested: 02/17/2023
Submitted By Organization: CT D05 - Monterey Construction Field Laboratory
Organization Address: 1529 Salinas Highway,
Organization City: Monterey
Organization State: CA
Organization Zipcode: 93940
Organization Email: wesley.rider@dot.ca.gov
Organization Phone: (831) 818-0254
General Comments for this Test:
Test Result Compliance: does not comply
Additional Comments When Verified:
Slump 3 inch

Test 4 of 4

DIME Test ID: 2023-02-17-16-6
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Verified Date: 03/17/2023
Date Tested: 02/17/2023
Submitted By Organization: CT D05 - Monterey Construction Field Laboratory
Organization Address: 1529 Salinas Highway,
Organization City: Monterey
Organization State: CA
Organization Zipcode: 93940
Organization Email: wesley.rider@dot.ca.gov
Organization Phone: (831) 818-0254
General Comments for this Test:
Test Result Compliance: not applicable
Additional Comments When Verified:
Temperature 60 F

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
2023-02-17-16-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders02/23/2023Not scheduledJoseph EsteybarCT D05 - Monterey Construction Field LaboratoryFrank Ortega
2023-02-17-16-2CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders02/28/202303/17/2023Joseph EsteybarCT D05 - Santa Cruz Field Laboratory3/3 28 day break acceptance.