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Sample Record for 2023-05-11-96

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: 2023-05-11-96
TL Number from the TL Form:
Sample Submitted By Organization: RMA Group - Rancho Cordova
Sample Organization Contact: (916) 631-7194
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 05/11/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/11/2023
The quantity of what the sample constitutes: 100 cy
A brief description of the sample: 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: 577750E6
The truck number from where the sample was collected: 2425
The batch plant ticket number from where the sample was collected: 420958
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Concrete truck
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: 2023-05-11-96-1
Test Method: CTM 557-June 2020: Method of Test for Temperature of Freshly Mixed Hydraulic Cement Concrete
Verified Date: 06/16/2023
Date Tested: 05/11/2023
Submitted By Organization: RMA Group - Rancho Cordova
Organization Address: 3150 Fitzgerald Road,
Organization City: Rancho Cordova
Organization State: CA
Organization Zipcode: 95742
Organization Email: mlowrance@rmacompanies.com
Organization Phone: (916) 631-7194
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Temperature 64 F

Test 2 of 2

DIME Test ID: 2023-05-11-96-2
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 06/16/2023
Date Tested: 05/11/2023
Submitted By Organization: RMA Group - Rancho Cordova
Organization Address: 3150 Fitzgerald Road,
Organization City: Rancho Cordova
Organization State: CA
Organization Zipcode: 95742
Organization Email: mlowrance@rmacompanies.com
Organization Phone: (916) 631-7194
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Slump 5 inch