Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214573 DEA: 073096U4 EFIS: 0719000091
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-210-R0.0/R9.7
Work Description: PLACE CONCRETE PAVEMENT, BARRIER, HMA, DRAINAGE, AND ELECTRICAL.
Location Description: LOS ANGELES COUNTY IN LOS ANGELES FROM INTERSTATE 5 TO WHEATLAND AVENUE UNDERCROSSING
Contractor Name: FLATIRON WEST INC
Contractor Address: 15335 FAIRFIELD RANCH ROAD, CHINO HILLS, CA 91709
Resident Engineer: Ridwan Salman Structure Rep.: Adriana Pimienta
DIME Sample ID: 2022-04-20-28
TL Number from the TL Form:
Sample Submitted By Organization: Kleinfelder, Incorporated - Los Angeles
Sample Organization Contact: (909) 833-5780
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 04/20/2022
Date that the sample was received by the laboratory/organization performing the testing: 04/21/2022
The quantity of what the sample constitutes: 1,300 CY
A brief description of the sample: A set of 4 JPCP concrete beam test specimens
From where was the sample collected: Job Site
Laboratory sample identification: 22-0857
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Flatiron Plant - Paxton off-Ramp
The concrete mix design number: JPCP-3215-06
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: Load 102
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Concrete from wheelbarrow
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2022-04-20-28-1
Test Method: CTM 523-May 2020: Method of Test for Flexural Strength of Concrete
Verified Date: 05/20/2022
Date Tested: 05/18/2022
Submitted By Organization: Kleinfelder, Incorporated - Los Angeles
Organization Address: 620 South Magnolia Avenue, Building G,
Organization City: Ontario
Organization State: CA
Organization Zipcode: 91762
Organization Email: mdorsch@kleinfelder.com
Organization Phone: (909) 833-5780
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens
|
2
|
Unit system used?
|
US Units
|
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
|
Is a beam dimensional correction factor used?
|
No
|
Modulus of rupture average
|
790 psi
|
Modulus of rupture
|
770 psi
|
Modulus of rupture 2
|
810 psi
|
Age of specimen
|
28 days
|
DIME Test ID: 2022-04-20-28-2
Test Method: CTM 523-May 2020: Method of Test for Flexural Strength of Concrete
Verified Date: 05/20/2022
Date Tested: 05/18/2022
Submitted By Organization: Kleinfelder, Incorporated - Los Angeles
Organization Address: 620 South Magnolia Avenue, Building G,
Organization City: Ontario
Organization State: CA
Organization Zipcode: 91762
Organization Email: mdorsch@kleinfelder.com
Organization Phone: (909) 833-5780
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens
|
2
|
Unit system used?
|
US Units
|
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
|
Is a beam dimensional correction factor used?
|
No
|
Modulus of rupture average
|
760 psi
|
Modulus of rupture
|
750 psi
|
Modulus of rupture 2
|
770 psi
|
Age of specimen
|
28 days
|