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Sample Record for 2021-04-15-12

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

Project Information

Project ID: 213746 DEA: 080Q75U4 EFIS: 0817000114 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD,RIV-60-R4.6/R9.9, R0.0/12.2
Work Description: REPLACEMENT OF TWO OUTSIDE LANES AND CONCRETE SLABS
Location Description:
Contractor Name: J McLoughlin Engineering
Contractor Address: 10641 Fulton Court, Rancho Cucamonga, CA 91730
Resident Engineer: Ashraf Mohamed Structure Rep.: Ching Chuang

Sample Information

DIME Sample ID: 2021-04-15-12
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: 04/15/2021
Date that the sample was received by the laboratory/organization performing the testing: 04/16/2021
The quantity of what the sample constitutes: 3 beams
A brief description of the sample: Concrete beams
From where was the sample collected: Job Site
Laboratory sample identification: 85-ISR-2A,85-ISR-2B,85-ISR-2C
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: RV Concrete Inc

Material Information

The concrete mix design number: CTS 65 EHI
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 Job Site 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 3

DIME Test ID: 2021-04-15-12-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 04/19/2021
Date Tested: 04/18/2021
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:
Additional Comments When Verified:
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Fracture occurred at a capped section No
Modulus of rupture 510 psi

Test 2 of 3

DIME Test ID: 2021-04-15-12-2
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 04/19/2021
Date Tested: 04/18/2021
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:
Additional Comments When Verified:
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Fracture occurred at a capped section No
Modulus of rupture 520 psi

Test 3 of 3

DIME Test ID: 2021-04-15-12-3
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 04/19/2021
Date Tested: 04/18/2021
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:
Additional Comments When Verified:
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Fracture occurred at a capped section No
Modulus of rupture 570 psi

Tests Assigned to this Sample

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