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Sample Record for 2021-10-27-20

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

Project Information

Project ID: 215556 DEA: 081L6504 EFIS: 0820000131 QA Service Level: 1
DIST-CO-RTE-PM: 08--,58-
Work Description:
Location Description:
Contractor Name: FEC Future Contractors & Engineers, Inc
Contractor Address: 184 Technology Dr., Ste 2, Irvine, CA 92618
Resident Engineer: Larry Canuti Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-10-27-20
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: 10/27/2021
Date that the sample was received by the laboratory/organization performing the testing: 10/27/2021
The quantity of what the sample constitutes: 6
A brief description of the sample: PCC Rapid set beams
From where was the sample collected: Job Site
Laboratory sample identification: 10082021-SET NO 8
Structure unique identifier:
Structure name: RTE 58 WB LN 2 PM 14dot 05
The fabricator/manufacturer/facility name: FEC

Material Information

The concrete mix design number: SM446BR2
The truck number from where the sample was collected: NA
The batch plant ticket number from where the sample was collected: NA
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: AT THE JOB SITE
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: 2021-10-27-20-1
Test Method: ASTM C293-10: Standard Test Method for Flexural Strength of Concrete (Using Simple Beam With Center-Point Loading)
Verified Date: 11/08/2021
Date Tested: 11/06/2021
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 850 psi

Test 2 of 3

DIME Test ID: 2021-10-27-20-2
Test Method: ASTM C293-10: Standard Test Method for Flexural Strength of Concrete (Using Simple Beam With Center-Point Loading)
Verified Date: 11/08/2021
Date Tested: 11/06/2021
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 870 psi

Test 3 of 3

DIME Test ID: 2021-10-27-20-3
Test Method: ASTM C293-10: Standard Test Method for Flexural Strength of Concrete (Using Simple Beam With Center-Point Loading)
Verified Date: 11/08/2021
Date Tested: 11/06/2021
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 900 psi