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Sample Record for 2022-01-09-1

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

Project Information

Project ID: 215690 DEA: 074W9504 EFIS: 0720000200 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-91-R12.1/R20.7
Work Description: INDIVIDUAL SLAB REPLACEMENT.
Location Description: LOS ANGELES COUNTY IN LONG BEACH AND CERRITOS FROM ATLANTIC AVENUE UNDERCROSSING TO THE ORANGE COUNTY LINE
Contractor Name: PETERSON-CHASE GENERAL ENGINEERING CONSTRUCTION, INC.
Contractor Address: 16351 Construction Circle West, Irvine, CA 92606
Resident Engineer: Thang Ton Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2022-01-09-1
TL Number from the TL Form: NA
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Department Acceptance
Type of Material: Concrete
Sample Taken Date: 01/09/2022
Date that the sample was received by the laboratory/organization performing the testing: 01/09/2022
The quantity of what the sample constitutes: 200 cy
A brief description of the sample: ISR-RSC Beams
From where was the sample collected: Job Site
Laboratory sample identification: 22-0036
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Short Load Concrete Inc

Material Information

The concrete mix design number: CTS-65-EHI
The truck number from where the sample was collected: 15
The batch plant ticket number from where the sample was collected: NA
Concrete batch plant: NA
The fabricator/manufacturer designation for the sample: NA
A detailed description of where the material sample was collected: Discharge from BACK OF concrete truck CHUTE into wheelbarrow.
Where the material sample would have been placed if not sampled: PAVEMENT SLAB
From Lot No.:
Bag Lot No.:
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2022-01-09-1-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 01/12/2022
Date Tested: 01/12/2022
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 817-0387
General Comments for this Test: 1 hour average beam break test result is 480 psi.
Test Result Compliance: complies
Additional Comments When Verified:
Number of specimens 3
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 740 psi
Modulus of rupture 2 740 psi
Modulus of rupture average 730 psi
Modulus of rupture 3 710 psi