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Sample Record for 2022-02-06-2

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Project Information

Project ID: 214671 DEA: 07303904 EFIS: 0714000044 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-10-31.2/37.2
Work Description: LANE REPLACEMENT
Location Description: LOS ANGELES COUNTY IN BALDWIN PARK AND WEST COVINA FROM 0.1 MILE EAST OF THE 10/605 SEPARATION TO 0.3 MILE WEST OF CITRUS STREET OVERCROSSING
Contractor Name: Sierra Landscape Development Inc.
Contractor Address: 2209 1/2 Chico Ave., South El Monte CA, 91733
Resident Engineer: Hai Hong Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2022-02-06-2
TL Number from the TL Form:
Sample Submitted By Organization: Kleinfelder, Incorporated - Los Angeles
Sample Organization Contact: (909) 833-5780
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 02/06/2022
Date that the sample was received by the laboratory/organization performing the testing: 02/06/2022
The quantity of what the sample constitutes: 780 CY
A brief description of the sample: A set of 3 JPCP-RSC concrete beam test specimens
From where was the sample collected: Job Site
Laboratory sample identification: 22-0222
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Security Paving Burbank Batch Plant

Material Information

The concrete mix design number: G3-21-PRS-237
The truck number from where the sample was collected: Load 115
The batch plant ticket number from where the sample was collected: 183932
Concrete batch plant: Security Paving Burbank Batch Plant
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Concrete from 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: 2022-02-06-2-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 02/16/2022
Date Tested: 02/16/2022
Submitted By Organization: Kleinfelder, Incorporated - Los Angeles
Organization Address: 620 South Magnolia Avenue, Building G,
Organization City: Ontario
Organization State: CA
Organization Zipcode: 91762
Organization Email: mdorsch@kleinfelder.com
Organization Phone: (909) 833-5780
General Comments for this Test: EB 10 Fwy between Frazier and Francisquito. Lane # 3, STA: 1764+10 to1778+10.
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 10 days
Modulus of rupture 700 psi
Modulus of rupture 2 780 psi
Modulus of rupture average 740 psi
Modulus of rupture 3 750 psi