Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994090 DEA: 01434804 EFIS: 0100000672
QA Service Level: 1
DIST-CO-RTE-PM: 01-MEN-1-62.0/62.3
Work Description: Pudding Creek Bridge Widening
Location Description: MENDOCINO COUNTY IN FORT BRAGG FROM ELM STREET TO PUDDING CREEK ROAD 421
Contractor Name: MCM Construction, Inc.
Contractor Address: P.O. Box 620, North Highland, CA 95660
Resident Engineer: Roozbeh Hadipour Structure Rep.: David Rivas
DIME Sample ID: 2023-06-01-53
TL Number from the TL Form:
Sample Submitted By Organization: Con-Fab California Corporation - Lathrop
Sample Organization Contact: (209) 249-4700
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 06/01/2023
Date that the sample was received by the laboratory/organization performing the testing: 06/02/2023
The quantity of what the sample constitutes: 1cubic ft. of Concrete for Testing
A brief description of the sample: 1cubic ft. of Concrete for Testing
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Con-Fab California, LLC
The concrete mix design number: VER-85LV
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 8672
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Bed 2, 3rd Truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2023-06-01-53-1
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Verified Date: 06/08/2023
Date Tested: 06/02/2023
Submitted By Organization: Con-Fab California Corporation - Lathrop
Organization Address: 1910 Lathrop Road,
Organization City: Lathrop
Organization State: CA
Organization Zipcode: 95330
Organization Email: dannyc@confabca.com
Organization Phone: (209) 249-4717
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Unit system used?
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US Units
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Number of specimens
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3
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Test performed
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With no density determined
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Apparent mass of submerged cylinder 1
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8.85 lb
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Average diameter of cylinder 1
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4.00 in
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Average diameter of cylinder 2
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4.00 in
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Average diameter of cylinder 3
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4.00 in
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Cross sectional area of cylinder 1
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12.56 in^2
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Cross sectional area of cylinder 2
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12.56 in^2
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Cross sectional area of cylinder 3
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12.56 in^2
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Compressive strength (to nearest 10 psi)
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4930 psi
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Maximum load on cylinder 1
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60835 lb
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Maximum load on cylinder 2
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61235 lb
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Maximum load on cylinder 3
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63795 lb
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Type of fracture pattern of cylinder 1
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5
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Type of fracture pattern of cylinder 2
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5
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Type of fracture pattern of cylinder 3
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4
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Comment on any defect in either specimen or caps (Max 250 Characters)
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no data
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Correction factor for cylinder 1
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1.00
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Correction factor for cylinder 2
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1.00
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Correction factor for cylinder 3
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1.00
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Age of specimen
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1 days
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Age of specimen in hours
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0 hours
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Serial number of delivery ticket, if available
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no data
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DIME Test ID: 2023-06-01-53-2
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 06/08/2023
Date Tested: 06/01/2023
Submitted By Organization: Con-Fab California Corporation - Lathrop
Organization Address: 1910 Lathrop Road,
Organization City: Lathrop
Organization State: CA
Organization Zipcode: 95330
Organization Email: dannyc@confabca.com
Organization Phone: (209) 249-4717
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
DIME Test ID: 2023-06-01-53-3
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Verified Date: 06/08/2023
Date Tested: 06/01/2023
Submitted By Organization: Con-Fab California Corporation - Lathrop
Organization Address: 1910 Lathrop Road,
Organization City: Lathrop
Organization State: CA
Organization Zipcode: 95330
Organization Email: dannyc@confabca.com
Organization Phone: (209) 249-4717
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
