Sample Record for 2022-01-05-38
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 211260 DEA: 072159U4 EFIS: 0715000160
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,ORA-5-0.0/1.5, 44.3/44.4
Work Description: CONSTRUCT HOV LANES AND MIX FLOW LANES.
Location Description: LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 TOWNSGATE RD. SUITE 200, WESTLAKE VILLAGE, CA 91361
Resident Engineer: George Saker Structure Rep.: Danny Lalonde
Sample Information
DIME Sample ID: 2022-01-05-38
TL Number from the TL Form: Unknown
Sample Submitted By Organization: G3 Quality, Incorporated - Cerritos
Sample Organization Contact: (562) 321-9840
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 01/05/2022
Date that the sample was received by the laboratory/organization performing the testing: 01/05/2022
The quantity of what the sample constitutes: 1 Bag
A brief description of the sample: Rock and Sand
From where was the sample collected: Source
Laboratory sample identification: Mix G3-15-3600-590
Structure unique identifier: 00-0000
Structure name:
The fabricator/manufacturer/facility name: Security Florance
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-19-0025::IRWINDALE
The fabricator's/manufacturer's product name for the sample: Set 1
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: unknown
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number: G3-15-3600-590
Lot number: 1
Sublot number: 1
Aggregate Mix Number:
Test Results
