Sample Record for 2022-01-30-9
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214524 DEA: 07304504 EFIS: 0714000067
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-57-R0.0/R4.5
Work Description: CONCRETE PAVEMENT, CONCRETE BARRIER, AND ELECTRICAL WORK.
Location Description: LOS ANGELES COUNTY IN DIAMOND BAR AND CITY OF INDUSTRY FROM ORANGE COUNTY LINE TO ROUTE 57/60 SEPARATION
Contractor Name: Griffith Company
Contractor Address: 3050 E. Birch Street, Brea, CA 92821
Resident Engineer: Martin Sandoval Structure Rep.: Avtar Bains
Sample Information
DIME Sample ID: 2022-01-30-9
TL Number from the TL Form:
Sample Submitted By Organization: CT D07 - Plant Services
Sample Organization Contact: 562-345-3126
Type of Sample: Department Acceptance
Type of Material: Aggregate
Sample Taken Date: 01/30/2022
Date that the sample was received by the laboratory/organization performing the testing: 02/02/2022
The quantity of what the sample constitutes: Two Bags
A brief description of the sample: Coarse and fine aggregate
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vanguard at the 57 Freeway
Material Information
Source Identification (SMARA, name of Pit or Job Site): Vulcan
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: Conveyor Belt
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number: 690HE4X12
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
