Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993192 DEA: 024H4404 EFIS: 0218000119
QA Service Level: 1
DIST-CO-RTE-PM: 02-PLU-70-0.0/29.9
Work Description: CONSTRUCT SOLDIER PILE RETAINING WALL, REPAIR RSP AND HMA PAVING.
Location Description: PLUMAS COUNTY AT VARIOUS LOCATIONS FROM BUTTE COUNTY LINE TO 3.1 MILES WEST OF ROUTE 89
Contractor Name: Q & D CONSTRUCTION, INC
Contractor Address: 1050 S 21st STREET, SPARKS, NV 89431
Resident Engineer: Mike Zdenek Structure Rep.: Unknown
DIME Sample ID: 2023-05-15-99
TL Number from the TL Form:
Sample Submitted By Organization: CT D03 - Chico Field Laboratory
Sample Organization Contact: (916) 799-4305
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 05/15/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/19/2023
The quantity of what the sample constitutes: (3) 4X8 Cylinders
A brief description of the sample: Laboratory Compression Test
From where was the sample collected: Job Site
Laboratory sample identification: 23-097
Structure unique identifier:
Structure name: Textured Wall Piles 193-183
The fabricator/manufacturer/facility name: Shasta Ready Mix
The concrete mix design number: CT-67SSLA50
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 0000000
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Textured Wall pile 193- plie 183
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2023-05-15-99-1
Test Method: ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Capped in accordance with ASTM C1231 - Unbonded Elastomeric Pad Cap
Submitted By Organization: CT D03 - Chico Field Laboratory
Organization Address: 2707 Notre Dame Boulevard,
Organization City: Chico
Organization State: CA
Organization Zipcode: 95928
Organization Email: bmckeehan@ghirardelliassoc.com
Organization Phone: (916) 799-4305
Data has not been verified.
DIME Test ID: 2023-05-15-99-2
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Submitted By Organization: CT D03 - Chico Field Laboratory
Organization Address: 2707 Notre Dame Boulevard,
Organization City: Chico
Organization State: CA
Organization Zipcode: 95928
Organization Email: bmckeehan@ghirardelliassoc.com
Organization Phone: (916) 799-4305
Data has not been verified.
