DIME - Test Summary

Summary for Test 2021-03-30-12-3

Test performed: ASTM C143-20

Project Identifiers	Project ID: 213653 DEA: 044G8204 EFIS: 0413000049
DIST-CO-RTE-PM	04-MRN-101-10.6/10.8
Award Date	05/05/2020
Closeout Date	08/14/2023
Work Description	REPLACE SAN RAFAEL HARBOR BRIDGE (ABC)
Location Description	MARIN COUTY, IN SAN RAFAEL, FROM ROUTE 101 NORTHBOUND OFF-RAMP TO 2ND STREET
QA Service Level	1 (Verified on 05/31/2019)

Sample Taken Date	03/30/2021	Sample Unique Key	12
Will the laboratory/organization for which you are a member perform testing on this material sample?	Yes	Date that the sample was received by the laboratory/organization performing the testing	03/31/2021
Sample type	Quality Control	A brief description of the sample	6x12 concrete cylinders
The quantity of what the sample constitutes	13 CY	From where was the sample collected	Fabricator
First name of sampler or witnessed by	Stephen	Last name of sampler or witnessed by	Haynes
Title of sampler	QC Inspector Technician	Telephone number of sampler	9253317125
Laboratory sample identification		Linked DIME Sample ID
The fabricator/manufacturer/facility name	KIE-CON, INC	Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name

Material Type	Concrete	The concrete mix design number	K4500x
The truck number from where the sample was collected		The batch plant ticket number from where the sample was collected	109860
Concrete batch plant		The fabricator/manufacturer designation for the sample	20-030C 3/30/21
A detailed description of where the material sample was collected	Concrete sample from wheelbarrow	Where the material sample would have been placed if not sampled	Abutment
From Lot No.		Bag Lot No.

DIME Sample ID: 2021-03-30-12

DIME Test ID: 2021-03-30-12-3

Testing Lab: Kie-Con, Incorporated - Antioch

Test Method: ASTM C143-20: Standard Test Method for Slump of Hydraulic-Cement Concrete

Test Release Date: 2021-09-15

Input Type: Calculated

Tester's full name: Stephen Haynes

Date of test: 03/30/2021

Slump: 9.25 inch

General comments (publicly viewable) (Max 1000 characters):

Test was verified on 9/15/2021 ✔