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Sample Record for 2020-08-04-27

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

Project Information

Project ID: 214466 DEA: 081F1414 EFIS: 0815000231 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-15-15-54.2/54.3
Work Description: Slab & lane replacement with JPCP & precast conc pavement, place HMA.
Location Description: Riverside and San Diego County
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 Townsgate Road, Suite 200, Westlake Village, CA 91361
Resident Engineer: Mike Bergevin Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2020-08-04-27
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: 9512323690
Type of Sample: Department Acceptance
Type of Material: Concrete
Sample Taken Date: 08/04/2020
Date that the sample was received by the laboratory/organization performing the testing: 08/05/2020
The quantity of what the sample constitutes: 4 Beams
A brief description of the sample: Concrete beams
From where was the sample collected: Job Site
Laboratory sample identification: 7A1, 7A2, 7B1, 7B2
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Rainbow, Temecula

Material Information

The concrete mix design number: G3-20-PCC-214
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: TT1
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: On Job Site at Concrete Truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test results on following page(s): 4

Test Results

Test 1 of 4

DIME Test ID: 2020-08-04-27-1
Test Method: CTM 523-July 2012: Method of Test for Flexural Strength of Concrete
Verified Date: 08/24/2020
Date Tested: 08/17/2020
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
What test method is being used? Third-Point Loading
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Modulus of rupture 540 psi

Test 2 of 4

DIME Test ID: 2020-08-04-27-2
Test Method: CTM 523-July 2012: Method of Test for Flexural Strength of Concrete
Verified Date: 08/24/2020
Date Tested: 08/17/2020
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
What test method is being used? Third-Point Loading
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Modulus of rupture 500 psi

Test 3 of 4

DIME Test ID: 2020-08-04-27-3
Test Method: CTM 523-July 2012: Method of Test for Flexural Strength of Concrete
Verified Date: 09/04/2020
Date Tested: 09/01/2020
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
What test method is being used? Third-Point Loading
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Modulus of rupture 660 psi

Test 4 of 4

DIME Test ID: 2020-08-04-27-4
Test Method: CTM 523-July 2012: Method of Test for Flexural Strength of Concrete
Verified Date: 09/04/2020
Date Tested: 09/01/2020
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
What test method is being used? Third-Point Loading
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Modulus of rupture 600 psi