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Sample Record for 2021-06-08-12

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: 2021-06-08-12
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: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 06/08/2021
Date that the sample was received by the laboratory/organization performing the testing: 06/09/2021
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: 11ISA1,11ISA2,11ISB1,11ISB2
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Coffman Specialties, Inc

Material Information

The concrete mix design number: 1906-31
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 5

DIME Test ID: 2021-06-08-12-1
Test Method: CTM 523-July 2012: Method of Test for Flexural Strength of Concrete
Verified Date: 06/14/2021
Date Tested: 06/11/2021
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 590 psi

Test 2 of 5

DIME Test ID: 2021-06-08-12-2
Test Method: CTM 523-July 2012: Method of Test for Flexural Strength of Concrete
Verified Date: 06/14/2021
Date Tested: 06/11/2021
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 610 psi

Test 3 of 5

DIME Test ID: 2021-06-08-12-3
Test Method: CTM 556-January 2018: Method of Test for Slump of Fresh Portland Cement Concrete
Verified Date: 06/14/2021
Date Tested: 06/08/2021
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:
Slump 1 inch

Test 4 of 5

DIME Test ID: 2021-06-08-12-4
Test Method: CTM 504-June 2010: Method of Test for Determining Air Content of Freshly Mixed Concrete by the Pressure Method
Verified Date: 06/14/2021
Date Tested: 06/08/2021
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:
Air Content 5 %

Test 5 of 5

DIME Test ID: 2021-06-08-12-5
Test Method: CTM 518-June 2010: Method of Test for Unit Weight of Fresh Concrete
Verified Date: 06/14/2021
Date Tested: 06/08/2021
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:
Unit weight of the concrete 143.6 lb/ft^3
Volume of the concrete 10.4 yd^3
Cement content 690.2 lb/yd^3

Tests Assigned to this Sample

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