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Sample Record for 2021-02-09-41

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

Project Information

Project ID: 213707 DEA: 081C38U4 EFIS: 0817000196 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-10-6.7/R25.1
Work Description: Remove concrete pavement and base, and place HMA and JPCP
Location Description: ROUTE 10/60 SEPARATION IN BEAUMONT TO ROUTE 10/111 SEPARATION NEAR CABAZON.
Contractor Name: Coffman Specialties
Contractor Address: 9685 Via Excelencia, San Diego, CA 92126
Resident Engineer: Elvira Lenart Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-02-09-41
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: 02/09/2021
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: JPCP beams
From where was the sample collected: Job Site
Laboratory sample identification: 12JJA1, 12JJA2
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Coffman Specialties, Inc

Material Information

The concrete mix design number: 1906-11
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: tt
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 2

DIME Test ID: 2021-02-09-41-1
Test Method: CTM 523-July 2012: Method of Test for Flexural Strength of Concrete
Verified Date: 05/05/2021
Date Tested: 04/29/2021
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: complies
Additional Comments When Verified:
What test method is being used? Third-Point Loading
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Modulus of rupture 650 psi

Test 2 of 2

DIME Test ID: 2021-02-09-41-2
Test Method: CTM 523-July 2012: Method of Test for Flexural Strength of Concrete
Verified Date: 05/05/2021
Date Tested: 04/29/2021
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: complies
Additional Comments When Verified:
What test method is being used? Third-Point Loading
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Modulus of rupture 670 psi

Tests Assigned to this Sample

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