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Sample Record for 2023-05-06-1

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

Project Information

Project ID: 993154 DEA: 120R3404 EFIS: 1218000079 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-73-12.9/R26.8
Work Description: REPLACE APPROACH SLABS, JOINT SEAL, AND APPLY METHACRYLATE ON BRIDGES.
Location Description: ORANGE COUNTY AT VARIOUS LOCATIONS FROM MOULTON PARKWAY UNDERCROSSING IN LAGUNA NIGUEL TO BRISTOL STREET UNDERCROSSING IN COSTA MESA
Contractor Name: PETERSON-CHASE GENERAL ENGINEERING CONSTRUCTION, INC.
Contractor Address: 16351 CONSTRUCTION CIR W, IRVINE, CA 92606
Resident Engineer: Nabil J. Ruda Structure Rep.: Ali Jenabzadeh

Sample Information

DIME Sample ID: 2023-05-06-1
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: 05/06/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/06/2023
The quantity of what the sample constitutes: 3
A brief description of the sample: 6x6x18 Beam
From where was the sample collected: Job Site
Laboratory sample identification: 23-0153
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Unknown

Material Information

The concrete mix design number: CTS-65-EHI
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: Concrete from wheelbarrow
Where the material sample would have been placed if not sampled: NB MacArthur Blvd onramp to N 73 north of San Diego
From Lot No.:
Bag Lot No.:
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2023-05-06-1-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 05/10/2023
Date Tested: 05/09/2023
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:
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 680 psi
Modulus of rupture 2 690 psi
Modulus of rupture average 690 psi
Modulus of rupture 3 710 psi