Sample Record for 2026-07-23-89
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000483 DEA: 120S1404 EFIS: 1219000098
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-1-21.5/31.1,32.7
Work Description: INSTALL CONC BARRIER, CURB, HMA PVMT, TRAFFIC STRIPE AND MARKINGS.
Location Description: ORANGE COUNTY IN AND NEAR HUNTINGTON BEACH AND SEAL BEACH FROM SANTA ANA RIVER BRIDGE TO ANDERSON STREET AND AT SEAL BEACH BOULEVARD
Contractor Name: CHUMO CONSTRUCTION, INC.
Contractor Address: Unknown
Resident Engineer: Imad Karam Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2026-07-23-89
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: JMF Verification
Type of Material: Aggregate
Sample Taken Date: 07/23/2026
Date that the sample was received by the laboratory/organization performing the testing: 08/21/2026
The quantity of what the sample constitutes: 4 Bags of Combined Aggregate, 2 Bags of Combined RAP
A brief description of the sample: 3/4"HMA-A-SP R15 NO LAS
From where was the sample collected: Manufacturer
Laboratory sample identification: 0444A-26
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: All American Asphalt - Corona
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-33-0005
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: Belt Cut at the Plant
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
