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Sample Record for 2024-06-23-42

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

Project Information

Project ID: 994966 DEA: 073255U4 EFIS: 0722000129 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-605-20.2/26
Work Description: INDIVIDUAL SLAB REPLACEMENT, COLD PLANE AC
Location Description: LOS ANGELES COUNTY IN BALDWIN PARK AND IRWINDALE FROM ROUTE 10/605 SEPARATION TO 0.2 MILE NORTH OF ROUTE 210/605 SEPARATION
Contractor Name: Peterson Chase General Engineering
Contractor Address: 16351 Construction Circle West, Irvine, CA 92606
Resident Engineer: Steven Taing Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2024-06-23-42
TL Number from the TL Form:
Sample Submitted By Organization: Alta Vista Solutions - Whittier
Sample Organization Contact: (510) 542-9827
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 06/23/2024
Date that the sample was received by the laboratory/organization performing the testing: 06/23/2024
The quantity of what the sample constitutes: 10 cubic yards
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 24-1588
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: N/A

Material Information

The concrete mix design number: CTS-65-EHI
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: wheelbarrow
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 2

DIME Test ID: 2024-06-23-42-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 08/13/2024
Date Tested: 07/03/2024
Submitted By Organization: Alta Vista Solutions - Whittier
Organization Address: 12409 Slauson Avenue, Suite I,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90606
Organization Email: nicholas.hoffmann@oneatlas.com
Organization Phone: (510) 542-9827
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? Stress
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? Yes
Age of specimen 10 days
Modulus of rupture 660 psi
Modulus of rupture average 650 psi
Modulus of rupture 2 680 psi
Modulus of rupture 3 620 psi

Test 2 of 2

DIME Test ID: 2024-06-23-42-2
Test Method: CTM 557-June 2020: Method of Test for Temperature of Freshly Mixed Hydraulic Cement Concrete
Verified Date: 08/13/2024
Date Tested: 06/23/2024
Submitted By Organization: Alta Vista Solutions - Whittier
Organization Address: 12409 Slauson Avenue, Suite I,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90606
Organization Email: nicholas.hoffmann@oneatlas.com
Organization Phone: (510) 542-9827
General Comments for this Test: Log # 24-1587 - Fabrication
Test Result Compliance:
Additional Comments When Verified:
Temperature 81 F