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Sample Record for 2023-06-06-66

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Project Information

Project ID: 213749 DEA: 120C1104 EFIS: 1200000633 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-57-20.3/21.6
Work Description: SR-57 Lambert Interchange Project: WIDEN BRIDGES AND CONSTRUCT RW, SW, HMA, JPCP AND ELECTRICAL SYSTEMS.
Location Description: ORANGE COUNTY IN BREA FROM 0.6 MILE SOUTH TO 0.7 MILE NORTH OF LAMBERT ROAD UNDERCROSSING
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 13170 TELFAIR AVENUE, SYLMAR, CA 91342
Resident Engineer: Steven Kim Structure Rep.: Theodore Pham

Sample Information

DIME Sample ID: 2023-06-06-66
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: 06/06/2023
Date that the sample was received by the laboratory/organization performing the testing: 06/06/2023
The quantity of what the sample constitutes: 4
A brief description of the sample: 6x6x18 Beam
From where was the sample collected: Job Site
Laboratory sample identification: 23-0181
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Security Paving

Material Information

The concrete mix design number: 1605760
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: LA5 5 plus 00
From Lot No.:
Bag Lot No.:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2023-06-06-66-1
Test Method: CTM 523-May 2020: Method of Test for Flexural Strength of Concrete
Verified Date: 06/22/2023
Date Tested: 06/16/2023
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 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 580 psi
Modulus of rupture 560 psi
Modulus of rupture 2 600 psi
Age of specimen 10 days

Test 2 of 2

DIME Test ID: 2023-06-06-66-2
Test Method: CTM 523-May 2020: Method of Test for Flexural Strength of Concrete
Verified Date: 07/04/2023
Date Tested: 07/04/2023
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 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 660 psi
Modulus of rupture 630 psi
Modulus of rupture 2 740 psi
Age of specimen 28 days