Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212324 DEA: 033F5104 EFIS: 0313000020
QA Service Level: 1
DIST-CO-RTE-PM: 03-YUB-20-R18.1/R20.1
Work Description: Construct bridge, realign curve & widen shoulders.
Location Description: Construction on state highway in Yuba County near Smartsville from the Yuba River Bridge to 0.3 mile east of Smartsville Road.
Contractor Name: Flatiron West, Inc.
Contractor Address: 2100 Goodyear Road, Benicia, CA 94510
Resident Engineer: Aaron Chamberlin Structure Rep.: Brent Bullard
DIME Sample ID: 2021-05-21-34
TL Number from the TL Form:
Sample Submitted By Organization: Trinity Engineering Laboratories, Incorporated - Fresno
Sample Organization Contact: (559) 292-2188
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 05/21/2021
Date that the sample was received by the laboratory/organization performing the testing: 05/22/2021
The quantity of what the sample constitutes: 4 cylinders
A brief description of the sample: PCC
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: A and A Concrete Supply Inc
The concrete mix design number: Z5685220
The truck number from where the sample was collected: 0618
The batch plant ticket number from where the sample was collected: 3175396
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2021-05-21-34-1
Test Method: ASTM C143-10a: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 08/17/2021
Date Tested: 05/21/2021
Submitted By Organization: Trinity Engineering Laboratories, Incorporated - Fresno
Organization Address: 2473 North Sunnyside Avenue,
Organization City: Fresno
Organization State: CA
Organization Zipcode: 93727
Organization Email: mhorn@trinityeng.co
Organization Phone: (559) 260-6841
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
DIME Test ID: 2021-05-21-34-2
Test Method: CTM 504-June 2010: Method of Test for Determining Air Content of Freshly Mixed Concrete by the Pressure Method
Verified Date: 08/17/2021
Date Tested: 05/21/2021
Submitted By Organization: Trinity Engineering Laboratories, Incorporated - Fresno
Organization Address: 2473 North Sunnyside Avenue,
Organization City: Fresno
Organization State: CA
Organization Zipcode: 93727
Organization Email: mhorn@trinityeng.co
Organization Phone: (559) 260-6841
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
DIME Test ID: 2021-05-21-34-3
Test Method: CTM 557-July 2012: Method of Test for Temperature of Freshly Mixed Portland Cement Concrete
Verified Date: 08/17/2021
Date Tested: 05/21/2021
Submitted By Organization: Trinity Engineering Laboratories, Incorporated - Fresno
Organization Address: 2473 North Sunnyside Avenue,
Organization City: Fresno
Organization State: CA
Organization Zipcode: 93727
Organization Email: mhorn@trinityeng.co
Organization Phone: (559) 260-6841
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Temperature of the freshly mixed concrete
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70 F
|
DIME Test ID: 2021-05-21-34-4
Test Method: CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete Cylinders
Verified Date: 08/17/2021
Date Tested: 06/18/2021
Submitted By Organization: Trinity Engineering Laboratories, Incorporated - Fresno
Organization Address: 2473 North Sunnyside Avenue,
Organization City: Fresno
Organization State: CA
Organization Zipcode: 93727
Organization Email: mhorn@trinityeng.co
Organization Phone: (559) 260-6841
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens
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2
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Average Compressive Strength (to nearest 10)
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4740 lb/in^2
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Cylinder Age
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28 days
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Break Description of Cylinder 1 (if not 'cone')
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3
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Break Description of Cylinder 2 (if not 'cone')
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3
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