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Sample Record for 2025-01-06-15

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Project Information

Project ID: 993141 DEA: 060V1204 EFIS: 0616000207 QA Service Level: 1
DIST-CO-RTE-PM: 06-MAD-99-R6.9/R7.6
Work Description: Cottonwood Creek Bridge Replacement - REPLACE BRIDGES AND CONSTRUCT RETAINING WALLS.
Location Description: MADERA COUNTY NEAR MADERA FROM 0.4 MILE SOUTH OF COTTONWOOD CREEK BRIDGE TO 0.1 MILE NORTH OF AVENUE 12 OVERCROSSING
Contractor Name: Security Paving Company, Inc.
Contractor Address: 3075 Townsgate Road, Westlake Village CA 91361
Resident Engineer: Din Dadawalla Structure Rep.: Ye Yang

Sample Information

DIME Sample ID: 2025-01-06-15
TL Number from the TL Form:
Sample Submitted By Organization: CT D06 - Millbrook Field Laboratory
Sample Organization Contact: (559) 341-3953
Type of Sample: Acceptance
Type of Material: Concrete
Sample Taken Date: 01/06/2025
Date that the sample was received by the laboratory/organization performing the testing: 01/06/2025
The quantity of what the sample constitutes: 450 CY
A brief description of the sample: 9 Cement Beams
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Builders Ashlan

Material Information

The concrete mix design number: ND15518c
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 1307685
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: from Cement Truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2025-01-06-15-1
Test Method: CTM 523-May 2020: Method of Test for Flexural Strength of Concrete
Verified Date: 01/13/2025
Date Tested: 01/13/2025
Submitted By Organization: CT D06 - Millbrook Field Laboratory
Organization Address: 1352 W. Olive Ave,
Organization City: Fresno
Organization State: CA
Organization Zipcode: 93728
Organization Email: tomas.silva@dot.ca.gov
Organization Phone: (559) 417-5341
General Comments for this Test:
Test Result Compliance: does not comply
Additional Comments When Verified:
Number of specimens 3
Unit system used? US Units
Does the testing machine measure load or stress on the beam specimen? Load
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Is a beam dimensional correction factor used? No
Modulus of rupture average 525 psi
Modulus of rupture 600 psi
Modulus of rupture 2 490 psi
Modulus of rupture 3 490 psi
Age of specimen 7 days

Test 2 of 2

DIME Test ID: 2025-01-06-15-2
Test Method: CTM 523-May 2020: Method of Test for Flexural Strength of Concrete
Verified Date: 02/04/2025
Date Tested: 02/03/2025
Submitted By Organization: CT D06 - Millbrook Field Laboratory
Organization Address: 1352 W. Olive Ave,
Organization City: Fresno
Organization State: CA
Organization Zipcode: 93728
Organization Email: tomas.silva@dot.ca.gov
Organization Phone: (559) 417-5341
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Number of specimens 3
Unit system used? US Units
Does the testing machine measure load or stress on the beam specimen? Load
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Is a beam dimensional correction factor used? No
Modulus of rupture average 765 psi
Modulus of rupture 745 psi
Modulus of rupture 2 795 psi
Modulus of rupture 3 755 psi
Age of specimen 28 days