DIME - Test Summary

Summary for Test 2024-03-29-6-3

Test performed: CTM 556-January 2018

Project Identifiers	Project ID: 993715 DEA: 010G1404 EFIS: 0116000129
DIST-CO-RTE-PM	01-HUM-96,169-VAR
Award Date	11/16/2022
Closeout Date	Not set
Work Description	HUM 96-169 5 Bridges Rail Upgrade (Do not include in project name: STRUCTURAL STEEL, CONCRETE BARRIER, POLYESTER CONCRETE OVERLAY)
Location Description	HUMBOLDT COUNTY ON ROUTES 96 AND 169 AT VARIOUS LOCATIONS (Bridge Nos. 04-0215, 04-0059, 04-0063, 04-0225, 04-0061)
QA Service Level	1 (Verified on 04/19/2022)

Sample Taken Date	03/29/2024	Sample Unique Key	6
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	11/19/2023
Sample type	Quality Assurance	A brief description of the sample	Type II/V Cement
The quantity of what the sample constitutes	37 CY	From where was the sample collected	Job Site
First name of sampler or witnessed by	Ed	Last name of sampler or witnessed by	Ericson
Title of sampler	ASR	Telephone number of sampler	(510) 882-9529
Laboratory sample identification		Linked DIME Sample ID
The fabricator/manufacturer/facility name	Mercer Fraser Company, Willow Creek Plant	Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier	12-04-0225
Structure name	Bluff Creek Bridge

Material Type	Concrete	The concrete mix design number	MFWCBRDKSLAG
The truck number from where the sample was collected	684	The batch plant ticket number from where the sample was collected	WC12450
Concrete batch plant	Willow Creek Mercer Fraser Plant	The fabricator/manufacturer designation for the sample	Plant
A detailed description of where the material sample was collected	CHUTE FROM TRUCK	Where the material sample would have been placed if not sampled	Overhang Deck RT
From Lot No.		Bag Lot No.

DIME Sample ID: 2024-03-29-6

DIME Test ID: 2024-03-29-6-3

Testing Lab: CT D01 - District 1 Materials Laboratory

Test Method: CTM 556-January 2018: Method of Test for Slump of Fresh Portland Cement Concrete

Test Release Date: 2024-03-29

Input Type: Measured

Tester's full name: Laura Cangas

Date of test: 03/29/2024

Slump: 4.5 inch

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Test was verified on 3/29/2024 ✔