Sample Record for 2025-08-24-6
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 995228 DEA: 07347904 EFIS: 0718000123
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-405-31.2/41.4
Work Description: COLD PLANE, PLACE HMA, RHMA, JPCP, ISR, & REPLACE BRIDGE SLABS.
Location Description: LOS ANGELES FROM WILSHIRE BOULEVARD UNDERCROSSING TO VICTORY BOULEVARD UNDERCROSSING
Contractor Name: RASMUSSEN/VANGUARD
Contractor Address: 28548 Livingston Ave, Valencia , CA,91355-4171
Resident Engineer: Denrick Bautista Structure Rep.: Gon Choi
Sample Information
DIME Sample ID: 2025-08-24-6
TL Number from the TL Form:
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 08/24/2025
Date that the sample was received by the laboratory/organization performing the testing: 08/24/2025
The quantity of what the sample constitutes: 720 sqft
A brief description of the sample: Aggregate Base
From where was the sample collected: Job Site
Laboratory sample identification: 25-2838
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: On-Site
Material Information
Source Identification (SMARA, name of Pit or Job Site): Job Site Material
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: CTM 231 Test Holes
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
