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

Sample Record for 2020-06-02-11

Project Information

Project ID: 213707 DEA: 081C38U4 EFIS: 0817000196 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-10-6.7/R25.1
Work Description: Remove concrete pavement and base, and place HMA and JPCP
Contractor Name: Coffman Specialties Contractor Address: 9685 Via Excelencia
Resident Engineer: Elvira Lenart Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2020-06-02-11
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: (951) 840-8328
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 06/02/2020
Date that the sample was received by the laboratory/organization performing the testing: 06/03/2020
The quantity of what the sample constitutes: 3 beams
A brief description of the sample: PCC Rapid set beams
From where was the sample collected: Job Site
Laboratory sample identification: 17RA, 17RB, 17RC
Structure unique identifier:
Structure name:

Material Information

The concrete mix design number: 2010-007
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: tt
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
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: Unknown
From Lot No.: Unknown
Bag Lot No.: Unknown

Test Results

Test Information 2 of 3

DIME Test ID: 2020-06-02-11-2
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 06/11/2020
Date Tested: 06/05/2020
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria St
Test General Comments:
Additional Comments When Verified:
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Fracture occurred at a capped section No
Modulus of rupture 720 psi