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Sample Record for 2021-09-02-30

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

Project Information

Project ID: 215188 DEA: 080F5434 EFIS: 0817000239 Permit Numbers: 0823NMC0369 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-I-15,SR-91-6.1-7.6
Work Description: I-15 ELC: 15/91 Express Lanes Connector Project (ELC)
Location Description: Junction of I-15 and SR-91 in Corona, CA
Contractor Name: Myers-Rados Joint Venture
Contractor Address: 629 N. Main Street, Suite C3, Corona, CA 92878
Resident Engineer: Roy Fisher Structure Rep.: Alhakem Alina

Sample Information

DIME Sample ID: 2021-09-02-30
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: Acceptance
Type of Material: Concrete
Sample Taken Date: 09/02/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/03/2021
The quantity of what the sample constitutes: 4 Beams
A brief description of the sample: Concrete beams
From where was the sample collected: Job Site
Laboratory sample identification: 1JA1, 1JA2, 1JB1, 1JB2
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Cemex, Fontana

Material Information

The concrete mix design number: 1605762
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: TTI
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: On Job Site at Concrete Truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 4

DIME Test ID: 2021-09-02-30-1
Test Method: CTM 523-May 2020: Method of Test for Flexural Strength of Concrete
Verified Date: 09/13/2021
Date Tested: 09/12/2021
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Number of specimens no data
Unit system used? US Units
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
Is a beam dimensional correction factor used? No
Modulus of rupture 590 psi
Age of specimen 10 days

Test 2 of 4

DIME Test ID: 2021-09-02-30-2
Test Method: CTM 523-May 2020: Method of Test for Flexural Strength of Concrete
Verified Date: 09/13/2021
Date Tested: 09/12/2021
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Number of specimens no data
Unit system used? US Units
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
Is a beam dimensional correction factor used? No
Modulus of rupture 650 psi
Age of specimen 10 days

Test 3 of 4

DIME Test ID: 2021-09-02-30-3
Test Method: CTM 523-July 2012: Method of Test for Flexural Strength of Concrete
Verified Date: 09/30/2021
Date Tested: 09/30/2021
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
What test method is being used? Third-Point Loading
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Modulus of rupture 720 psi

Test 4 of 4

DIME Test ID: 2021-09-02-30-4
Test Method: CTM 523-July 2012: Method of Test for Flexural Strength of Concrete
Verified Date: 09/30/2021
Date Tested: 09/30/2021
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: kaushalkumar.talati@dot.ca.gov
Organization Phone: (951) 840-8328
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
What test method is being used? Third-Point Loading
Fracture initiates in the tension surface Within the Middle Third of the Span Length
Modulus of rupture 750 psi