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Sample Record for 2025-10-11-4

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 1001065 DEA: 070Y1304 EFIS: 0724000134 QA Service Level: 1
DIST-CO-RTE-PM: 07-VEN-101-25.9/30.6
Work Description: MAINLINE INDIVIDUAL SLAB REPLACEMENT.
Location Description: VENTURA COUNTY IN VENTURA FROM 0.1 MILE WEST OF TELEPHONE RD UNDERCROSSING TO VENTURA AVENUE UNDERCROSSING
Contractor Name: RV CONCRETE, INC.
Contractor Address: 605 east commerce street, Anaheim CA 92801
Resident Engineer: Ranjit singh Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2025-10-11-4
TL Number from the TL Form:
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Acceptance
Type of Material: Concrete
Sample Taken Date: 10/11/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/12/2025
The quantity of what the sample constitutes: 200 CY
A brief description of the sample: ISR-RSC Beams
From where was the sample collected: Job Site
Laboratory sample identification: 25-3284
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Short Load Concrete

Material Information

The concrete mix design number: CTS-65-EHI
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: NA
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Discharge from concrete truck into wheelbarrow.
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2025-10-11-4-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 10/15/2025
Date Tested: 10/14/2025
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 407-6963
General Comments for this Test: NB US-101 Main St. & Seaward Ave.
Test Result Compliance:
Additional Comments When Verified:
Number of specimens 3
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
Fracture occurred at a capped section No
Is a beam dimensional correction factor used? No
Age of specimen 3 days
Modulus of rupture 620 psi
Modulus of rupture 2 670 psi
Modulus of rupture average 640 psi
Modulus of rupture 3 640 psi