Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000612 DEA: 120R57U4 EFIS: 1223000131
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-405-11.4/24.2
Work Description: PLACE JPCP (RSC) AND RHMA, AND MODIFY ELECTRICAL SYSTEMS.
Location Description: ORANGE COUNTY FROM HARBOR BOULEVARD UNDERCROSSING IN COSTA MESA TO LOS ANGELES COUNTY LINE AT ROSSMOOR
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 9050 Norris Ave. #200, Westlake Village, CA 91361
Resident Engineer: Dennis Nguyen Structure Rep.: maribel Munoz Blanco
DIME Sample ID: 2025-07-22-70
TL Number from the TL Form:
Sample Submitted By Organization: CT D12 - Huntington Beach Field Laboratory
Sample Organization Contact: 9492798846
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 07/22/2025
Date that the sample was received by the laboratory/organization performing the testing: 07/22/2025
The quantity of what the sample constitutes: 3
A brief description of the sample: Concrete beams
From where was the sample collected: Job Site
Laboratory sample identification: 25-0265
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Unknown
The concrete mix design number: G3-25-CTS-389
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: Unknown
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: "A" Line 1259+00~1269+00
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2025-07-22-70-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 08/01/2025
Date Tested: 08/01/2025
Submitted By Organization: CT D12 - Huntington Beach Field Laboratory
Organization Address: 19601 Beach Boulevard,
Organization City: Huntington Beach
Organization State: CA
Organization Zipcode: 92648
Organization Email: frank.mai@dot.ca.gov
Organization Phone: (949) 279-8846
General Comments for this Test:
Test Result Compliance: complies
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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710 psi
|
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Modulus of rupture 2
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700 psi
|
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Modulus of rupture average
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690 psi
|
|
Modulus of rupture 3
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660 psi
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