Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212112 DEA: 080C2514 EFIS: 0816000076 COOP: 081645
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-10-0.0/13.2
Work Description: Design-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes
Location Description: LA/SBD County Line to PM 13.2 near I-15
Contractor Name: Lane-Security Paving Joint Venture
Contractor Address: 3450 Centre Lake Drive, 1st Floor, Ontario, CA 91761
Resident Engineer: Jose Corona Structure Rep.: Luis Negrete
DIME Sample ID: 2022-05-22-16
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Blythe Field Testing Laboratory
Sample Organization Contact: 9096015132
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 05/22/2022
Date that the sample was received by the laboratory/organization performing the testing: 05/23/2022
The quantity of what the sample constitutes: 2
A brief description of the sample: cast concrete beams
From where was the sample collected: Job Site
Laboratory sample identification: set 12A B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: LANEsecurity paving
The concrete mix design number: G3-18-PCC-229HE
The truck number from where the sample was collected: NA
The batch plant ticket number from where the sample was collected: TIME 22HRS PCC
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: AT THE JOBSITE
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2022-05-22-16-1
Test Method: ASTM C293-10: Standard Test Method for Flexural Strength of Concrete (Using Simple Beam With Center-Point Loading)
Verified Date: 06/21/2023
Date Tested: 06/15/2023
Submitted By Organization: CT D08 - Blythe Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: brian.teh@dot.ca.gov
Organization Phone: (909) 601-5132
General Comments for this Test: AVE PSI OF 2 BEAMS 758 FOR 570 PSI@ 28 DAYS REQUI
Test Result Compliance: complies
Additional Comments When Verified:
|
Unit system used?
|
US Units
|
|
Modulus of rupture
|
765 psi
|
DIME Test ID: 2022-05-22-16-2
Test Method: ASTM C293-10: Standard Test Method for Flexural Strength of Concrete (Using Simple Beam With Center-Point Loading)
Verified Date: 06/21/2023
Date Tested: 06/19/2023
Submitted By Organization: CT D08 - Blythe Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: brian.teh@dot.ca.gov
Organization Phone: (909) 601-5132
General Comments for this Test: AVE PSI OF 2 BEAMS 758 FOR 570 PSI@ 28 DAYS REQUI
Test Result Compliance: complies
Additional Comments When Verified:
|
Unit system used?
|
US Units
|
|
Modulus of rupture
|
750 psi
|
