Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994579 DEA: 070W4004 EFIS: 0722000046
QA Service Level: 1
DIST-CO-RTE-PM: 07-VEN-101-30.9/R36.3;R40.6/R43.6
Work Description: CONCRETE PAVEMENT SLABS REPLACEMENT & SLURRY SHOULDER.
Location Description: VENTURA COUNTY IN AND NEAR VENTURA FROM VENTURA RIVER BRIDGE TO 0.4 MILE SOUTH OF PADRE JUAN CANYON ROAD OVERCROSSING AND FROM 0.4 MILE NORTH OF PUNTA GORDA PEDESTRIAN UNDERCROSSING TO BATES ROAD UNDERCROSSING.
Contractor Name: RE CHAFFEE CONSTRUCTION INC
Contractor Address: 1253 EVERGREEN ROAD, SUITE 3, WRIGHTWOOD CA 92397
Resident Engineer: Azin Sadeghi Structure Rep.: Unknown
DIME Sample ID: 2023-11-14-50
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: Department Acceptance
Type of Material: Concrete
Sample Taken Date: 11/14/2023
Date that the sample was received by the laboratory/organization performing the testing: 11/15/2023
The quantity of what the sample constitutes: 130 CY
A brief description of the sample: ISR-RSC Beams
From where was the sample collected: Job Site
Laboratory sample identification: 23-2024
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Short Load Concrete
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: NA
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: 2023-11-14-50-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 11/18/2023
Date Tested: 11/17/2023
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: VEN SB Rte. 101
North of PCH On-Ramp to SB
Test Result Compliance:
Additional Comments When Verified:
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Number of specimens
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3
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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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Fracture occurred at a capped section
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No
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Is a beam dimensional correction factor used?
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Yes
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Age of specimen
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3 days
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Modulus of rupture
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530 psi
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Modulus of rupture average
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550 psi
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Modulus of rupture 2
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590 psi
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Modulus of rupture 3
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520 psi
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