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Sample Record for 2023-11-05-1

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

Project Information

Project ID: 994648 DEA: 070W3904 EFIS: 0722000045 QA Service Level: 1
DIST-CO-RTE-PM: 07-VEN-101-10.7/26.7
Work Description: SLURRY SEAL.
Location Description: VENTURA COUNTY FROM CAMARILLO SPRINGS ROAD UNDERCROSSING IN CAMARILLO TO MAIN STREET UNDERCROSSING IN VENTURA
Contractor Name: INTERMOUNTAIN SLURRY SEAL, INC.
Contractor Address: 1120 TERMINAL WAY, RENO NV 89502
Resident Engineer: Denrick Bautista Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2023-11-05-1
TL Number from the TL Form:
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Acceptance
Type of Material: Concrete
Sample Taken Date: 11/05/2023
Date that the sample was received by the laboratory/organization performing the testing: 11/05/2023
The quantity of what the sample constitutes: 14 cu. yd.
A brief description of the sample: ISR-RSC
From where was the sample collected: Job Site
Laboratory sample identification: 23-1931
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: SLC

Material Information

The concrete mix design number: CTS-65-GBR
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: from volumetric concrete mixer truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2023-11-05-1-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 11/11/2023
Date Tested: 11/08/2023
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 817-0387
General Comments for this Test:
Test Result Compliance:
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 580 psi
Modulus of rupture 2 610 psi
Modulus of rupture average 600 psi
Modulus of rupture 3 620 psi