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Sample Record for 2019-01-22-3

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

Project Information

Project ID: 209694 DEA: 080J0704 EFIS: 0800000282 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-215-0.6/1.7
Work Description: (Alternative Delivery) The CMGC project will reconstruct and improve interchange of I-215 and Barton Road in the City of Grand Terrace, CA.
Location Description: Grade separation at Intersection of I-215 and Barton Road near Grand Terrace, CA. ? On I-215 between I-10 and SR-60.
Contractor Name: Myers / Rados-Southern California Jobsite Office
Contractor Address: 12210 Michigan St., Suite D, Grand Terrace, CA 92313
Resident Engineer: Fereydoon Alipanah Structure Rep.: Tim Flores

Sample Information

DIME Sample ID: 2019-01-22-3
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: 01/22/2019
Date that the sample was received by the laboratory/organization performing the testing: 01/23/2019
The quantity of what the sample constitutes: 6 Beams
A brief description of the sample: Concrete beams
From where was the sample collected: Job Site
Laboratory sample identification: 14A1,14A2, 14B1, 14B2, 14C1,14C2
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: Robertson Riverside

Material Information

The concrete mix design number: SC675B38
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: TT1
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: on jobsite at concrete truck
Where the material sample would have been placed if not sampled: Unknown
From Lot No.: Unknown
Bag Lot No.: Unknown

Test Results

Test 1 of 4

DIME Test ID: 2019-01-22-3-1
Test Method: CTM 523-July 2012: Method of Test for Flexural Strength of Concrete
Verified Date: 02/22/2019
Date Tested: 02/05/2019
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: does not comply
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 no data

Test 2 of 4

DIME Test ID: 2019-01-22-3-2
Test Method: CTM 523-July 2012: Method of Test for Flexural Strength of Concrete
Verified Date: 02/22/2019
Date Tested: 02/05/2019
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: does not comply
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 no data

Test 3 of 4

DIME Test ID: 2019-01-22-3-3
Test Method: CTM 523-July 2012: Method of Test for Flexural Strength of Concrete
Verified Date: 02/22/2019
Date Tested: 02/20/2019
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 no data

Test 4 of 4

DIME Test ID: 2019-01-22-3-4
Test Method: CTM 523-July 2012: Method of Test for Flexural Strength of Concrete
Verified Date: 02/22/2019
Date Tested: 02/20/2019
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 no data