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Sample Record for 2024-04-20-21

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

Project Information

Project ID: 994945 DEA: 081J6304 EFIS: 0818000086 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-215-3.6/6.0
Work Description: INDIVIDUAL SLAB REPLACEMENT (RSC) AND RHMA.
Location Description: SAN BERNARDINO COUNTY IN COLTON AND SAN BERNARDINO FROM 0.2 MILE SOUTH OF ROUTE 10/215 SEPARATION TO MILL STREET UNDERCROSSING
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 Townsgate Road, Suite 200, Westlake Village, CA 91361
Resident Engineer: Shaine Shahidi Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2024-04-20-21
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: 9512323690
Type of Sample: Acceptance
Type of Material: Concrete
Sample Taken Date: 04/20/2024
Date that the sample was received by the laboratory/organization performing the testing: 04/20/2024
The quantity of what the sample constitutes: 3 Beams
A brief description of the sample: 3 - 6X6X21 Rapid Set Concrete Beams
From where was the sample collected: Job Site
Laboratory sample identification: RSC24-2
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: G3 Quality, Inc.

Material Information

The concrete mix design number: G3-21-CTS-220
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 00000
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Back of 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): 2

Test Results

Test 1 of 2

DIME Test ID: 2024-04-20-21-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 06/20/2024
Date Tested: 04/23/2024
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: Beam A1
Test Result Compliance:
Additional Comments When Verified:
Number of specimens 1
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 3 days
Modulus of rupture 800 psi

Test 2 of 2

DIME Test ID: 2024-04-20-21-2
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 06/20/2024
Date Tested: 04/23/2024
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: Beam A2 & A3
Test Result Compliance:
Additional Comments When Verified:
Number of specimens 2
Does the testing machine measure load or stress on the beam specimen? Load
Fracture initiates in the tension surface Outside of the Middle Third of the Span Length by No More Than 5 Percent
Fracture occurred at a capped section No
Is a beam dimensional correction factor used? No
Age of specimen 3 days
Modulus of rupture 750 psi
Modulus of rupture average 830 psi
Modulus of rupture 2 900 psi