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Sample Record for 2022-05-10-40

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

Project Information

Project ID: 211260 DEA: 072159U4 EFIS: 0715000160 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,ORA-5-0.0/1.5, 44.3/44.4
Work Description: CONSTRUCT HOV LANES AND MIX FLOW LANES.
Location Description: LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 TOWNSGATE RD. SUITE 200, WESTLAKE VILLAGE, CA 91361
Resident Engineer: George Saker Structure Rep.: Danny Lalonde

Sample Information

DIME Sample ID: 2022-05-10-40
TL Number from the TL Form:
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Acceptance
Type of Material: Concrete
Sample Taken Date: 05/10/2022
Date that the sample was received by the laboratory/organization performing the testing: 05/10/2022
The quantity of what the sample constitutes: 10cuyd
A brief description of the sample: JPCP
From where was the sample collected: Fabricator
Laboratory sample identification: 22-1092
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Flatiron Plant - Paxton off-Ramp

Material Information

The concrete mix design number: G3-19-PCC-001
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: Load 5
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Discharge from concrete truck into wheelbarrow.
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2022-05-10-40-1
Test Method: CTM 523-May 2020: Method of Test for Flexural Strength of Concrete
Verified Date: 06/09/2022
Date Tested: 06/07/2022
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:
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 750 psi
Modulus of rupture 750 psi
Modulus of rupture 2 740 psi
Age of specimen 28 days