Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994245 DEA: 051H4304 EFIS: 0516000073
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-21.4/21.9
Work Description: REPLACE STRUCTURAL CONCRETE BRIDGES.
Location Description: SANTA BARBARA COUNTY IN GOLETA FROM ROUTE 101/217 SEPARATION TO 0.3 MILE NORTH OF SAN JOSE CREEK BRIDGE
Contractor Name: MCM CONSTRUCTION
Contractor Address: 6413 32nd Street, North Highlands, Ca 95660
Resident Engineer: Manny Yogarajah Structure Rep.: Fabian Velasco
DIME Sample ID: 2023-10-20-16
TL Number from the TL Form:
Sample Submitted By Organization: Con-Fab California, LLC
Sample Organization Contact: (661) 630-7162
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 10/20/2023
Date that the sample was received by the laboratory/organization performing the testing: 10/21/2023
The quantity of what the sample constitutes: 27 CY
A brief description of the sample: T-II/V Cement & Flyash Type F
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier: 51-0367L/R
Structure name: San Jose Creek Bridge
The fabricator/manufacturer/facility name: Con-Fab California, LLC - Shafter
The concrete mix design number: S9.8-25FA
The truck number from where the sample was collected: 89
The batch plant ticket number from where the sample was collected: 3886
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Sampled from wheelbarrow collected from chute of ready mix truck
Where the material sample would have been placed if not sampled: Box Girder
From Lot No.:
Bag Lot No.:
DIME Test ID: 2023-10-20-16-1
Test Method: CTM TEMP1-16: Test Method for Monitoring Precast Concrete Curing Temperature (Curing temperature)
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Avenue,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: (661) 630-3281
Data has not been verified.
DIME Test ID: 2023-10-20-16-2
Test Method: ASTM C143-10a: Standard Test Method for Slump of Hydraulic-Cement Concrete
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Avenue,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: (661) 630-3281
Data has not been verified.
DIME Test ID: 2023-10-20-16-3
Test Method: ASTM C1064-08: Standard Test Method for Temperature of Freshly Mixed Hydraulic-Cement Concrete
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Avenue,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: (661) 630-3281
Data has not been verified.
DIME Test ID: 2023-10-20-16-4
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Avenue,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: (661) 630-3281
Data has not been verified.
DIME Test ID: 2023-10-20-16-5
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Avenue,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: (661) 630-3281
Data has not been verified.
DIME Test ID: 2023-10-20-16-6
Test Method: ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete Specimens
Submitted By Organization: Con-Fab California, LLC
Organization Address: 701 Golds Avenue,
Organization City: Shafter
Organization State: CA
Organization Zipcode: 93263
Organization Email: trevorl@confabca.com
Organization Phone: (661) 630-3281
Data has not been verified.
