Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993828 DEA: 070W0704 EFIS: 0721000031
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-710-6.9/17.3
Work Description: INDIVIDUAL SLAB REPLACEMENT.
Location Description: LOS ANGELES COUNTY IN AND NEAR LONG BEACH FROM ROUTE 1/710 SEPARATION TO LOS ANGELES RIVER BRIDGE
Contractor Name: ALL AMERICAN ASPHALT
Contractor Address: Unknown
Resident Engineer: Jose FERRER Structure Rep.: Unknown
DIME Sample ID: 2023-05-14-5
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: Department Acceptance
Type of Material: Concrete
Sample Taken Date: 05/14/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/14/2023
The quantity of what the sample constitutes: 40 CY
A brief description of the sample: ISR-RSC
From where was the sample collected: Job Site
Laboratory sample identification: 23-0637
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Short Load Concrete
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: 1
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: Individual Slab Replacement
From Lot No.:
Bag Lot No.:
DIME Test ID: 2023-05-14-5-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 05/17/2023
Date Tested: 05/17/2023
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: SB Rte. 710 South of Imperial Hwy. Lane #1 & 2
Test Result Compliance:
Additional Comments When Verified:
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Number of specimens
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3
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Does the testing machine measure load or stress on the beam specimen?
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Stress
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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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Fracture occurred at a capped section
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No
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Is a beam dimensional correction factor used?
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No
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Age of specimen
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3 days
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Modulus of rupture
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900 psi
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Modulus of rupture average
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820 psi
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Modulus of rupture 2
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790 psi
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Modulus of rupture 3
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770 psi
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