Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994966 DEA: 073255U4 EFIS: 0722000129
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-605-20.2/26
Work Description: INDIVIDUAL SLAB REPLACEMENT, COLD PLANE AC
Location Description: LOS ANGELES COUNTY IN BALDWIN PARK AND IRWINDALE FROM ROUTE 10/605 SEPARATION TO 0.2 MILE NORTH OF ROUTE 210/605 SEPARATION
Contractor Name: Peterson Chase General Engineering
Contractor Address: 16351 Construction Circle West, Irvine, CA 92606
Resident Engineer: Steven Taing Structure Rep.: Unknown
DIME Sample ID: 2025-06-05-69
TL Number from the TL Form:
Sample Submitted By Organization: Alta Vista Solutions - Whittier
Sample Organization Contact: (510) 542-9827
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 06/05/2025
Date that the sample was received by the laboratory/organization performing the testing: 06/05/2025
The quantity of what the sample constitutes: 10 CY
A brief description of the sample: 3 RSC beams
From where was the sample collected: Job Site
Laboratory sample identification: 25-1805
Structure unique identifier:
Structure name: SB Arrow Highway OffRamp in IrwindaleRapit setting JPCP at Sta 214+36
The fabricator/manufacturer/facility name: N/A
The concrete mix design number: CTS-65EHI
The truck number from where the sample was collected: Truck 19
The batch plant ticket number from where the sample was collected: Load 5
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Jobsite
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2025-06-05-69-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 06/25/2025
Date Tested: 06/15/2025
Submitted By Organization: Alta Vista Solutions - Whittier
Organization Address: 12409 Slauson Avenue, Suite I,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90606
Organization Email: nicholas.hoffmann@oneatlas.com
Organization Phone: (510) 542-9827
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Number of specimens
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3
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Does the testing machine measure load or stress on the beam specimen?
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Load
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Fracture initiates in the tension surface
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Within the Middle Third of the Span Length
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Fracture occurred at a capped section
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No
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Is a beam dimensional correction factor used?
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No
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Age of specimen
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10 days
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Modulus of rupture
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920 psi
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Modulus of rupture 2
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920 psi
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Modulus of rupture average
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930 psi
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Modulus of rupture 3
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940 psi
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