Sample Record for 2025-06-27-73
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214649 DEA: 07316004 EFIS: 0715000194
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-14-60.70
Work Description: REHABILITATION FOR THE ON/OFF RAMPS AND ADJACENT SHOULDERS. UPGRADING METAL BEAM GUARDRAILS, AC DIKES, SIGN PANELS, CURB RAMPS, TRAFFIC LOOPS DETECTORS, AND SOME OTHER HIGHWAY APPURTENANCES.
Location Description: ROUTE 14 FROM PALMDALE BLVD TO KERN COUNTRY LINE.
Contractor Name: Guy F. Atkinson Construction LLC
Contractor Address: 18201 Von Karman Ave, Suite 800, Irvine, CA 92612
Resident Engineer: James Shih Structure Rep.: Hossein Sabbagh
Sample Information
DIME Sample ID: 2025-06-27-73
TL Number from the TL Form:
Sample Submitted By Organization: Alta Vista Solutions - Whittier
Sample Organization Contact: (510) 542-9827
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 06/27/2025
Date that the sample was received by the laboratory/organization performing the testing: 06/27/2025
The quantity of what the sample constitutes: 350 CY
A brief description of the sample: 6x12 JPCP cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 25-2108
Structure unique identifier:
Structure name: NB SR-14 Lane #3 at STA: 3791+01.
The fabricator/manufacturer/facility name: N/A
Material Information
The concrete mix design number: SCI-12622-1
The truck number from where the sample was collected: Truck or Ticket 35
The batch plant ticket number from where the sample was collected: Load 35
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Jobsite
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test Results
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| 2025-06-27-73-1 | CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders | 09/18/2025 | Not scheduled | SoCal Reports | Alta Vista Solutions - Whittier | | SoCal Reports |
143620
