Sample Record for 2024-09-12-39
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994903 DEA: 11430244 EFIS: 1118000033
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-125-9.3/13.0
Work Description: PLACE HMA, RHMA, SLAB REPLACEMENT, AND ELECTRICAL WORK.
Location Description: SAN DIEGO COUNTY IN AND NEAR LEMON GROVE FROM 0.3 MILE SOUTH OF ELKELTON PLACE UNDERCROSSING TO 0.2 MILE SOUTH OF ROUTE 125/94 SEPARATION
Contractor Name: HAZARD CONSTRUCTION ENGR LLC
Contractor Address: 10529 Vine Street, Lakeside, CA 92040
Resident Engineer: Sultan Ghazialam Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2024-09-12-39
TL Number from the TL Form:
Sample Submitted By Organization: Sequoia Consultants
Sample Organization Contact: (714) 974-6316
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 09/12/2024
Date that the sample was received by the laboratory/organization performing the testing: 09/12/2024
The quantity of what the sample constitutes: 1 per batch
A brief description of the sample: 1x4 concrete aggregates
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Associated R/M - Otay
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-37-0035
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: stockpile or belt cut
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
