Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993626 DEA: 070W0804 EFIS: 0721000034
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-405-28.0/31.6
Work Description: INDIVIDUAL SLAB REPLACEMENTS.
Location Description: LOS ANGELES COUNTY IN CULVER CITY AND LOS ANGELES FROM VENICE BOULEVARD SEPARATION TO WILSHIRE BOULEVARD UNDERCROSSING
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 Townsgate Rd,, Westlake Village, CA 91361
Resident Engineer: Frank Shin Structure Rep.: Unknown
DIME Sample ID: 2022-08-21-2
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: 08/21/2022
Date that the sample was received by the laboratory/organization performing the testing: 08/21/2022
The quantity of what the sample constitutes: 140 CY
A brief description of the sample: A set of 3 ISR-RSC Beams
From where was the sample collected: Job Site
Laboratory sample identification: 22-2144
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: NA
The concrete mix design number: G3-220
The truck number from where the sample was collected:
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: Discharge from back of concrete truck CHUTE into wheelbarrow.
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2022-08-21-2-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 08/24/2022
Date Tested: 08/24/2022
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:
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Number of specimens
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3
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Does the testing machine measure load or stress on the beam specimen?
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Load
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Fracture initiates in the tension surface
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Within the Middle Third of the Span Length
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Fracture occurred at a capped section
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Yes
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Is a beam dimensional correction factor used?
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No
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Age of specimen
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3 days
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Modulus of rupture
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660 psi
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Modulus of rupture 2
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670 psi
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Modulus of rupture average
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660 psi
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Modulus of rupture 3
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660 psi
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