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Sample Record for 2022-10-07-60

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Project Information

Project ID: 208973 DEA: 120H1004 EFIS: 1200000180 COOP: 120670 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-405,73,405,605-9.3/24.3
Work Description: (Alternative Delivery) San Diego Freeway (I-405) Improvement Project SR-73 to I-605, Design Build Project, Administered by Orange County Transportation Authority, Caltrans METS to perform Source Inspection per RFP.
Location Description: Orange and Los Angeles Counties: 12-ORA-405 PM 9.3/24.2 / 07-LA-405 PM 0.0/1.2 12-ORA-22 PM R0.7/R3.8 / 12-ORA-22 PM R0.5/R0.7 12-ORA-73 PM R27.2/R27.8 / 12-ORA-605 PM 3.5/R1.6 07-LA-605 PM R0.0/R1.2
Contractor Name: OC 405 Partners
Contractor Address: 3100 W Lake Center Dr, Santa Ana, CA 92704
Resident Engineer: Hank Alonso (reports) Structure Rep.: Alex Angha (reports)

Sample Information

DIME Sample ID: 2022-10-07-60
TL Number from the TL Form:
Sample Submitted By Organization: CT D12 - Huntington Beach Field Laboratory
Sample Organization Contact: 9492798846
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 10/07/2022
Date that the sample was received by the laboratory/organization performing the testing: 10/07/2022
The quantity of what the sample constitutes: 2 concrete beams+1 extra
A brief description of the sample: Concrete beams
From where was the sample collected: Job Site
Laboratory sample identification: 22-0387
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: OC 405 Partners

Material Information

The concrete mix design number: G3-18-PCC-127
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 1
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: SB Seal Beach ML
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 1

DIME Test ID: 2022-10-07-60-1
Test Method: CTM 523-May 2020: Method of Test for Flexural Strength of Concrete
Verified Date: 11/14/2022
Date Tested: 11/04/2022
Submitted By Organization: CT D12 - Huntington Beach Field Laboratory
Organization Address: 19601 Beach Boulevard,
Organization City: Huntington Beach
Organization State: CA
Organization Zipcode: 92648
Organization Email: frank.mai@dot.ca.gov
Organization Phone: (949) 279-8846
General Comments for this Test: Complies, Required = 570psi
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 680 psi
Modulus of rupture 650 psi
Modulus of rupture 2 700 psi
Age of specimen 28 days