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Sample Record for 2019-06-25-20

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

Project Information

Project ID: 209694 DEA: 080J0704 EFIS: 0800000282 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-215-0.6/1.7
Work Description: (Alternative Delivery) The CMGC project will reconstruct and improve interchange of I-215 and Barton Road in the City of Grand Terrace, CA.
Location Description: Grade separation at Intersection of I-215 and Barton Road near Grand Terrace, CA. ? On I-215 between I-10 and SR-60.
Contractor Name: Myers / Rados-Southern California Jobsite Office
Contractor Address: 12210 Michigan St., Suite D, Grand Terrace, CA 92313
Resident Engineer: Fereydoon Alipanah Structure Rep.: Flores, Tim

Sample Information

DIME Sample ID: 2019-06-25-20
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: (951) 840-8328
Type of Sample: Acceptance
Type of Material: Concrete
Sample Taken Date: 06/25/2019
Date that the sample was received by the laboratory/organization performing the testing: 06/26/2019
The quantity of what the sample constitutes: 6 Beams
A brief description of the sample: Concrete beams
From where was the sample collected: Job Site
Laboratory sample identification: 22A1,22A2, 22B1, 22B2, 22C1,22C2
Structure unique identifier: 42-xxxx
Structure name: Unknown
The fabricator/manufacturer/facility name: Robertson Riverside

Material Information

The concrete mix design number: SC675B38
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: TT1
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: on jobsite at concrete truck
Where the material sample would have been placed if not sampled: Unknown
From Lot No.: Unknown
Bag Lot No.: Unknown

Test Results

Test 1 of 2

DIME Test ID: 2019-06-25-20-1
Test Method: CTM 523-July 2012: Method of Test for Flexural Strength of Concrete
Verified Date: 07/09/2019
Date Tested: 07/09/2019
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria St,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
What test method is being used? Center-Point Loading
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Modulus of rupture no data

Test 2 of 2

DIME Test ID: 2019-06-25-20-2
Test Method: CTM 523-July 2012: Method of Test for Flexural Strength of Concrete
Verified Date: 07/09/2019
Date Tested: 07/09/2019
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria St,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
What test method is being used? Center-Point Loading
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Modulus of rupture no data

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.