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Sample Record for 2023-05-18-37

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

Project Information

Project ID: 994244 DEA: 051F6204 EFIS: 0514000039 QA Service Level: 1
DIST-CO-RTE-PM: 05-SCR-152-1.9
Work Description: WIDEN BRIDGE, CONCRETE BARRIER, AND MODIFY ELECTRICAL SYSTEM.
Location Description: SANTA CRUZ COUNTY NEAR WATSONVILLE AT CORRALITOS CREEK BRIDGE
Contractor Name: Bridgeway Civil Constructors, Inc
Contractor Address: 3333 Vaca Valley Parkway, Suite 2000, Vacaville, CA 95688
Resident Engineer: David Hopper Structure Rep.: David Galarza

Sample Information

DIME Sample ID: 2023-05-18-37
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: 05/18/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/19/2023
The quantity of what the sample constitutes: 72 CY
A brief description of the sample: Barrier Slab Concrete
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Graniterock

Material Information

The concrete mix design number: 077720
The truck number from where the sample was collected: 2424
The batch plant ticket number from where the sample was collected: 421062
Concrete batch plant: Graniterock
The fabricator/manufacturer designation for the sample:
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

Test 1 of 2

DIME Test ID: 2023-05-18-37-2
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Verified Date: 06/15/2023
Date Tested: 05/18/2023
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: complies
Additional Comments When Verified:
Temperature 68 F

Test 2 of 2

DIME Test ID: 2023-05-18-37-3
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 06/15/2023
Date Tested: 05/18/2023
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: complies
Additional Comments When Verified:
Slump 4.5 inch

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
2023-05-18-37-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders05/22/202306/15/2023Joseph EsteybarCT D05 - Monterey Construction Field LaboratoryFrank Ortega