Sample Record for 2021-12-21-13
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 213598 DEA: 051F75U4 EFIS: 0518000092
QA Service Level: 1
DIST-CO-RTE-PM: 05-MON-101-R36.9/47.7
Work Description: CRCP, SEISMIC RETROFIT, BRIDGE WIDENING AND MEDIAN BARRIER
Location Description: MONTEREY COUNTY IN AND NEAR KING CITY FROM 0.4 MILE SOUTH OF WILD HORSE ROAD OVERCROSSING TO TEAGUE AVENUE
Contractor Name: OHL USA, INC.
Contractor Address: 1920 Main St. Suite 310, Irvine, CA 92614
Resident Engineer: Adam Rianda Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2021-12-21-13
TL Number from the TL Form: 821579
Sample Submitted By Organization: CT D05 - San Luis Obispo District Laboratory
Sample Organization Contact: (559) 230-3109
Type of Sample: Department Acceptance
Type of Material: Aggregate
Sample Taken Date: 12/21/2021
Date that the sample was received by the laboratory/organization performing the testing: 12/21/2021
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: Class 1 Base
From where was the sample collected: Job Site
Laboratory sample identification: 21-C-041
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: OHL Stockpile
Material Information
Source Identification (SMARA, name of Pit or Job Site): Jobsite 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: Jobsite Stockpile
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1-1/2 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
