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Sample Record for 2023-09-20-4

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

Project Information

Project ID: 214830 DEA: 043G6304 EFIS: 0412000409 QA Service Level: 1
DIST-CO-RTE-PM: 04-SCL-4-SCl-9 -4.75/4.9
Work Description: Saratoga Creek Bridge Rehabilitation Project
Location Description: San Jose - Saratoga Creek
Contractor Name: Myers and Sons
Contractor Address: 4600 NORTHGATE BLVD, STE 100, SACRAMENTO, CA 95834
Resident Engineer: Arif Khan Structure Rep.: OANH BUI

Sample Information

DIME Sample ID: 2023-09-20-4
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: 09/20/2023
Date that the sample was received by the laboratory/organization performing the testing: 09/21/2023
The quantity of what the sample constitutes: 1 cubic ft. of Concrete for Testing
A brief description of the sample: 1 cubic ft. of Concrete taken from middle of batching
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: ConFab Lathrop

Material Information

The concrete mix design number: VER-98LV
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 9511
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Bed Echo, Truck 1
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 3

DIME Test ID: 2023-09-20-4-1
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 09/25/2023
Date Tested: 09/20/2023
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:
Slump 25 inch

Test 2 of 3

DIME Test ID: 2023-09-20-4-2
Test Method: ASTM C1064-17: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Verified Date: 09/25/2023
Date Tested: 09/20/2023
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:
Temperature 80 F

Test 3 of 3

DIME Test ID: 2023-09-20-4-3
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Verified Date: 09/25/2023
Date Tested: 09/21/2023
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:
Unit system used? US Units
Number of specimens 3
Test performed With no density determined
Capped in accordance with? no data
Apparent mass of submerged cylinder 1 8.87 lb
Average diameter of cylinder 1 4.00 in
Average diameter of cylinder 2 4.00 in
Average diameter of cylinder 3 4.00 in
Cross sectional area of cylinder 1 12.56 in^2
Cross sectional area of cylinder 2 12.56 in^2
Cross sectional area of cylinder 3 12.56 in^2
Compressive strength (to nearest 10 psi) 6950 psi
Maximum load on cylinder 1 86580 lb
Maximum load on cylinder 2 90825 lb
Maximum load on cylinder 3 85315 lb
Type of fracture pattern of cylinder 1 4
Type of fracture pattern of cylinder 2 4
Type of fracture pattern of cylinder 3 4
Comment on any defect in either specimen or caps (Max 250 Characters) no data
Correction factor for cylinder 1 1.00
Correction factor for cylinder 2 1.00
Correction factor for cylinder 3 1.00
Age of specimen 1 days
Age of specimen in hours 0 hours
Serial number of delivery ticket, if available no data