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Sample Record for 2021-08-07-3

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

Project Information

Project ID: 215444 DEA: 081H9314 EFIS: 0818000104 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD,RIV-71-R0.0/R8.5,R0.0/R2.9
Work Description: SLAB REPLACEMENT (RSC) AND FURNISHED POLYESTER CONCRETE OVERLAY.
Location Description: SAN BERNARDINO AND RIVERSIDE COUNTIES IN AND NEAR CHINO AND CHINO HILLS FROM LOS ANGELES COUNTY LINE TO 0.2 MILE SOUTH OF SANTA ANA RIVER BRIDGE
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-08-07-3
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: 08/07/2021
Date that the sample was received by the laboratory/organization performing the testing: 08/08/2021
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: 3RA,3RB,3RC
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Myers and Sons Construction

Material Information

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.:

Test Results

Test 1 of 3

DIME Test ID: 2021-08-07-3-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 08/13/2021
Date Tested: 08/10/2021
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:
Number of specimens 1
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Fracture occurred at a capped section No
Modulus of rupture 690 psi

Test 2 of 3

DIME Test ID: 2021-08-07-3-2
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 08/13/2021
Date Tested: 08/10/2021
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:
Number of specimens 1
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Fracture occurred at a capped section No
Modulus of rupture 610 psi

Test 3 of 3

DIME Test ID: 2021-08-07-3-3
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 08/13/2021
Date Tested: 08/10/2021
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:
Number of specimens 1
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Fracture occurred at a capped section No
Modulus of rupture 650 psi