Sample Record for 2024-03-27-29
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 215314 DEA: 07333004 EFIS: 0716000298
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5,5-15.1/22.9
Work Description: PROJECT PILOT 1
Location Description: LOS ANGELES COUNTY IN AND NEAR LOS ANGELES ON ROUTE 5 FROM 0.1 MILE SOUTH OF CALZONA STREET TO 0.1 MILE SOUTH OF RIVERSIDE DRIVE AND ROUTE 2 AT LOS ANGELES REGIONAL TRANSPORTATION MANAGEMENT CENTER
Contractor Name: Powell Constructors, Inc.
Contractor Address: 8555 Banana Ave, Fontana, CA 92335
Resident Engineer: Jerome Arabe Structure Rep.: Gon Choi
Sample Information
DIME Sample ID: 2024-03-27-29
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: Verification
Type of Material: Aggregate
Sample Taken Date: 03/27/2024
Date that the sample was received by the laboratory/organization performing the testing: 03/29/2024
The quantity of what the sample constitutes: 4 Bags Comb. Agg, 2 Bags Rap
A brief description of the sample: PSUE HMA-A-SP R15
From where was the sample collected: Manufacturer
Laboratory sample identification: 0152A-24
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: All American Asphalt-Irwindale
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 All American Irwindale Plant
Where the material sample would have been placed if not sampled: Asphalt Paving
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: 105793
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
