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Sample Record for 2021-01-10-2

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

Project Information

Project ID: 210837 DEA: 080J0804 EFIS: 0800000283 COOP: 081625 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-15-34.7/51.6
Work Description: (Alternative Delivery) DESIGN-BUILD OF THE INTERSTATE 15 EXPRESS LANES PROJECT
Location Description: Riverside County and SBD-15-0.0/1.3
Contractor Name: Skanska-Ames, Joint Venture
Contractor Address: 1801 California Avenue, Corona, CA 92881
Resident Engineer: Roy Fisher (reports) Structure Rep.: Roy Fisher

Sample Information

DIME Sample ID: 2021-01-10-2
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: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 01/10/2021
Date that the sample was received by the laboratory/organization performing the testing: 02/10/2021
The quantity of what the sample constitutes: 4 Beams
A brief description of the sample: concrete beams
From where was the sample collected: Job Site
Laboratory sample identification: 3RSC-A1, 3RSC-B1, 3RSC-C1
Structure unique identifier: 33-paving
Structure name: Unknown
The fabricator/manufacturer/facility name: security paving Corona

Material Information

The concrete mix design number: SM446B39
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: Discharge from concrete truck into wheelbarrow.
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 3

DIME Test ID: 2021-01-10-2-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 02/09/2021
Date Tested: 02/07/2021
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: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test:
Test Result Compliance: complies
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 28 days
Modulus of rupture 700 psi

Test 2 of 3

DIME Test ID: 2021-01-10-2-2
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 02/09/2021
Date Tested: 02/07/2021
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: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test:
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 28 days
Modulus of rupture 640 psi

Test 3 of 3

DIME Test ID: 2021-01-10-2-3
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 02/09/2021
Date Tested: 02/07/2021
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: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test:
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 28 days
Modulus of rupture 700 psi