Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994408 DEA: 051K03U4 EFIS: 0522000026
QA Service Level: 1
DIST-CO-RTE-PM: 05-SLO-101-
Work Description: !!PLEASE CC Office Engineer Barbara Riccardi on reports to RE and SR!! Construct 2 roundabouts in Montecito along US 101.
Location Description:
Contractor Name: Veronica Mchugh
Contractor Address: 5335 DEBBIE ROAD, SANTA BARBARA, CA 93111
Resident Engineer: Taylor Merlo Structure Rep.: Josh Madrigal
DIME Sample ID: 2023-06-03-10
TL Number from the TL Form:
Sample Submitted By Organization: CT D05 - Carpinteria Field Laboratory
Sample Organization Contact: (805) 621-3616
Type of Sample: Department Acceptance
Type of Material: Concrete
Sample Taken Date: 06/03/2023
Date that the sample was received by the laboratory/organization performing the testing: 06/13/2023
The quantity of what the sample constitutes: 30cy
A brief description of the sample: Concrete beams
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CEMEX Santa Barbara
The concrete mix design number: 1625995
The truck number from where the sample was collected: 10067296
The batch plant ticket number from where the sample was collected: 30769034
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Discharge from concrete truck into wheelbarrow.
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2023-06-03-10-1
Test Method: CTM 523-May 2020: Method of Test for Flexural Strength of Concrete
Verified Date: 06/30/2023
Date Tested: 06/13/2023
Submitted By Organization: CT D05 - Carpinteria Field Laboratory
Organization Address: 21 Griffin Road North,
Organization City: Windsor
Organization State: CT
Organization Zipcode: 06095-1590
Organization Email: dlachaine@trccompanies.com
Organization Phone: (805) 621-3616
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
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Number of specimens
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2
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Unit system used?
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US Units
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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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Is a beam dimensional correction factor used?
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Yes
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Modulus of rupture average
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630 psi
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Modulus of rupture
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670 psi
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Modulus of rupture 2
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590 psi
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Age of specimen
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9 days
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