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Testing Report for 2021-04-21-33-2

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

Project Information

DEA: 040A5394
EFIS: 0418000244
Project ID: 214114
QA Service Level: 1
DIST-CO-RTE-PM: 04-SOL-80,12-11.4/12.8, 2.1/2.8
Work Description: Widen EB SR-12 Connector, Construct 3 ramps & 2 box girder bridges, remove existing bridge, etc.
Location Description: I-80/I-680/Route 12 Interchange
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Fernando Dos Santos
Structure Rep.: Alejandro Lara

Sample Information

DIME Sample ID: 2021-04-21-33
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: 4/21/2021
Date that the sample was received by the laboratory/organization performing the testing: 4/21/2021
The quantity of what the sample constitutes: 100 CY
A brief description of the sample: Portland Cement Concrete
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Syar

Material Information

The concrete mix design number: CT063AC5
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 81141353
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Shoring Enclosures DS10
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Information

DIME Test ID: 2021-04-21-33-2
Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete
Date Tested: 4/21/2021
Verified Date: 8/3/2021
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 :

Submitted Test Results

Slump: 4 inch