Sample Record for 2022-10-07-60
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 208973 DEA: 120H1004 EFIS: 1200000180 COOP: 120670
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-405,73,405,605-9.3/24.3
Work Description: (Alternative Delivery) San Diego Freeway (I-405) Improvement Project SR-73 to I-605, Design Build Project, Administered by Orange County Transportation Authority, Caltrans METS to perform Source Inspection per RFP.
Location Description: Orange and Los Angeles Counties: 12-ORA-405 PM 9.3/24.2 / 07-LA-405 PM 0.0/1.2 12-ORA-22 PM R0.7/R3.8 / 12-ORA-22 PM R0.5/R0.7 12-ORA-73 PM R27.2/R27.8 / 12-ORA-605 PM 3.5/R1.6 07-LA-605 PM R0.0/R1.2
Contractor Name: OC 405 Partners
Contractor Address: 3100 W Lake Center Dr, Santa Ana, CA 92704
Resident Engineer: Hank Alonso (reports) Structure Rep.: Alex Angha (reports)
Sample Information
DIME Sample ID: 2022-10-07-60
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: 10/07/2022
Date that the sample was received by the laboratory/organization performing the testing: 10/07/2022
The quantity of what the sample constitutes: 2 concrete beams+1 extra
A brief description of the sample: Concrete beams
From where was the sample collected: Job Site
Laboratory sample identification: 22-0387
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: OC 405 Partners
Material Information
The concrete mix design number: G3-18-PCC-127
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 1
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: SB Seal Beach ML
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test Results
Test 1 of 1
DIME Test ID: 2022-10-07-60-1
Test Method: CTM 523-May 2020: Method of Test for Flexural Strength of Concrete
Verified Date: 11/14/2022
Date Tested: 11/04/2022
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: Complies, Required = 570psi
Test Result Compliance:
Additional Comments When Verified:
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Number of specimens
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2
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Unit system used?
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US Units
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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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Is a beam dimensional correction factor used?
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No
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Modulus of rupture average
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680 psi
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Modulus of rupture
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650 psi
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Modulus of rupture 2
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700 psi
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Age of specimen
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28 days
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