Sample Record for 2024-09-12-20
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 995193 DEA: 07356604 EFIS: 0719000026
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-605-R10.2/20.2
Work Description: LANE & SLAB REPLACEMENT, COLD PLANE & HMA OVERLAY.
Location Description: LOS ANGELES COUNTY IN SANTA FE SPRINGS, PICO RIVERA, WHITTIER, CITY OF INDUSTRY AND EL MONTE FROM TELEGRAPH ROAD UNDERCROSSING TO ROUTE 605/10 SEPARATION
Contractor Name: MYERS & SONS CONSTRUCTION, LLC
Contractor Address: 45 Morrison Ave, Sacramento, CA 95838
Resident Engineer: Jerome Arabe Structure Rep.: Tien Chu
Sample Information
DIME Sample ID: 2024-09-12-20
TL Number from the TL Form: C 003411
Sample Submitted By Organization: CT D07 - Plant Services
Sample Organization Contact: 562-345-3126
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 09/12/2024
Date that the sample was received by the laboratory/organization performing the testing: 09/13/2024
The quantity of what the sample constitutes: 7 CY
A brief description of the sample: Washed Concrete Sand
From where was the sample collected: Manufacturer
Laboratory sample identification: 045B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Myers and Sons Construction
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-19-0025
The fabricator's/manufacturer's product name for the sample: Martin Marietta Aggregates-Irwindale
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Truck
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: fine
The concrete mix design number: VTCS675
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
