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Sample Record for 2021-01-30-12

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

Project Information

Project ID: 213970 DEA: 080K1214 EFIS: 0815000245 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-12.5/14.8
Work Description: REPLACE PCC PAVEMENT WITH JPCP AND PRECAST JOINTED CONCRETE PAVEMENT.
Location Description: SAN BERNARDINO COUNTY IN FONTANA AND NEAR DEVORE FROM 0.3 MILE SOUTH OF SIERRA AVENUE UNDERCROSSING TO GLEN HELEN PARKWAY UNDERCROSSING
Contractor Name: OHL USA, INC
Contractor Address: 1920 MAIN STREET STE 310, Irvine, CA 92614
Resident Engineer: Vu Thanh Nguyen Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-01-30-12
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Barstow Field Laboratory 1
Sample Organization Contact: (760) 252-9216
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 01/30/2021
Date that the sample was received by the laboratory/organization performing the testing: 02/08/2021
The quantity of what the sample constitutes: 2
A brief description of the sample: Concrete beams
From where was the sample collected: Job Site
Laboratory sample identification: 16A 16B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: robertsons

Material Information

The concrete mix design number: 1553950
The truck number from where the sample was collected: CHUTE
The batch plant ticket number from where the sample was collected: load 61 AT 610CY
Concrete batch plant:
The fabricator/manufacturer designation for the sample: Robertsons Batch Plant Lucerne
A detailed description of where the material sample was collected: Back of Truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 2

DIME Test ID: 2021-01-30-12-1
Test Method: ASTM C293-10: Standard Test Method for Flexural Strength of Concrete (Using Simple Beam With Center-Point Loading)
Verified Date: 06/11/2021
Date Tested: 02/09/2021
Submitted By Organization: CT D08 - Barstow Field Laboratory 1
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:
Unit system used? US Units
Modulus of rupture 660 psi

Test 2 of 2

DIME Test ID: 2021-01-30-12-2
Test Method: ASTM C293-10: Standard Test Method for Flexural Strength of Concrete (Using Simple Beam With Center-Point Loading)
Verified Date: 06/11/2021
Date Tested: 02/09/2021
Submitted By Organization: CT D08 - Barstow Field Laboratory 1
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:
Unit system used? US Units
Modulus of rupture 640 psi