Sample Record for 2026-01-31-4
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1001440 DEA: 07370804 EFIS: 0720000139
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-30.6/31.6
Work Description: REMOVE CONCRETE PAVEMENT AND BASE, AND PLACE JPCP.
Location Description: LOS ANGELES COUNTY IN BURBANK FROM 0.2 MILE NORTH OF SAN FERNANDO BOULEVARD TO 0.2 MILE SOUTH OF COHASSET STREET
Contractor Name: SECURITY PAVING COMPANY INC.
Contractor Address: 3075 Towngate Road, St. 200, Westlake Village, CA 91361
Resident Engineer: danglong Tran Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2026-01-31-4
TL Number from the TL Form:
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: 01/31/2026
Date that the sample was received by the laboratory/organization performing the testing: 02/02/2026
The quantity of what the sample constitutes: 600 CY
A brief description of the sample: 1"x#4 agg.
From where was the sample collected: Fabricator
Laboratory sample identification: 0131261
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: National Ready Mix
Material Information
Source Identification (SMARA, name of Pit or Job Site): 19-CAN-01
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: 1"x#4 aggregates
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
