Sample Record for 2026-01-29-35
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000301 DEA: 07333704 EFIS: 0716000316
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-138-43.4/51.4
Work Description: CONSTRUCT ADA CURB RAMPS, SIDEWALK, AND DRIVEWAY.
Location Description: LOS ANGELES COUNTY IN PALMDALE FROM ROUTE 14 JUNCTION (SOUTH) TO AVENUE T
Contractor Name: A. M. CONCRETE, INC.
Contractor Address: 3075 Townsgate Road, Suite 200, Westlake Village, CA 91361
Resident Engineer: Roberto Martinez Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2026-01-29-35
TL Number from the TL Form:
Sample Submitted By Organization: Thompson Pipe Group - Los Angeles
Sample Organization Contact: (909) 201-5127
Type of Sample: Quality Control
Type of Material: Precast Concrete
Sample Taken Date: 01/29/2026
Date that the sample was received by the laboratory/organization performing the testing: 01/29/2026
The quantity of what the sample constitutes: 2.5cy
A brief description of the sample: 4x8 concrete cylinders
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Thompson pipe group
Material Information
The concrete mix design number: CT6002PH
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 272669
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Conveyor Belt
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test Results
