Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214524 DEA: 07304504 EFIS: 0714000067
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-57-R0.0/R4.5
Work Description: CONCRETE PAVEMENT, CONCRETE BARRIER, AND ELECTRICAL WORK.
Location Description: LOS ANGELES COUNTY IN DIAMOND BAR AND CITY OF INDUSTRY FROM ORANGE COUNTY LINE TO ROUTE 57/60 SEPARATION
Contractor Name: Griffith Company
Contractor Address: 3050 E. Birch Street, Brea, CA 92821
Resident Engineer: Martin Sandoval Structure Rep.: Avtar Bains
DIME Sample ID: 2023-04-07-33
TL Number from the TL Form:
Sample Submitted By Organization: Alta Vista Solutions - Whittier
Sample Organization Contact: (510) 542-9827
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 04/07/2023
Date that the sample was received by the laboratory/organization performing the testing: 04/08/2023
The quantity of what the sample constitutes: 10 cubic yards
A brief description of the sample: 2 JPCP Concrete Beams
From where was the sample collected: Job Site
Laboratory sample identification: 23-0398
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: n/a
The concrete mix design number: HE4X4B
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 13936
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Wheelbarrow
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2023-04-07-33-1
Test Method: CTM 523-May 2020: Method of Test for Flexural Strength of Concrete
Verified Date: 05/17/2023
Date Tested: 05/05/2023
Submitted By Organization: Alta Vista Solutions - Whittier
Organization Address: 12409 Slauson Avenue, Suite I,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90606
Organization Email: nicholas.hoffmann@oneatlas.com
Organization Phone: (510) 542-9827
General Comments for this Test:
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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1085 psi
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Modulus of rupture
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1125 psi
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Modulus of rupture 2
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1045 psi
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Age of specimen
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28 days
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