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Sample Record for 2024-05-01-86

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: 2024-05-01-86
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: 05/01/2024
Date that the sample was received by the laboratory/organization performing the testing: 05/01/2024
The quantity of what the sample constitutes: 6 Beams
A brief description of the sample: 2 Sets of 3 - 6X6X21 Rapid Set Concrete Beams
From where was the sample collected: Job Site
Laboratory sample identification: RSC27
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: 2024-05-01-86-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 06/20/2024
Date Tested: 05/04/2024
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: #27-1
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 3 days
Modulus of rupture 700 psi
Modulus of rupture 2 720 psi
Modulus of rupture average 710 psi
Modulus of rupture 3 710 psi

Test 2 of 2

DIME Test ID: 2024-05-01-86-2
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 06/20/2024
Date Tested: 05/04/2024
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: #27-2
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 3 days
Modulus of rupture 610 psi
Modulus of rupture 2 620 psi
Modulus of rupture average 620 psi
Modulus of rupture 3 640 psi