Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993128 DEA: 081M5404 EFIS: 0821000131
QA Service Level: 1
DIST-CO-RTE-PM: 08---
Work Description:
Location Description:
Contractor Name: BALTAZAR CONSTRUCTION,INC.
Contractor Address: 236 E. ARROW HWY, COVINA, CA 91722
Resident Engineer: Alam Mahfual Structure Rep.: Unknown
DIME Sample ID: 2021-07-16-50
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: 9512323690
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 07/16/2021
Date that the sample was received by the laboratory/organization performing the testing: 07/19/2021
The quantity of what the sample constitutes: 3 beams
A brief description of the sample: PCC Rapid set beams
From where was the sample collected: Job Site
Laboratory sample identification: 1RA,1RB,1RC
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: shortload concrete
The concrete mix design number: 800-3RSC
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: TTI
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
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:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2021-07-16-50-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 07/23/2021
Date Tested: 07/19/2021
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: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
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
|
3 days
|
Modulus of rupture
|
760 psi
|
DIME Test ID: 2021-07-16-50-2
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 07/23/2021
Date Tested: 07/19/2021
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: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
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
|
3 days
|
Modulus of rupture
|
750 psi
|
DIME Test ID: 2021-07-16-50-3
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 07/23/2021
Date Tested: 07/19/2021
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: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
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
|
3 days
|
Modulus of rupture
|
810 psi
|