Sample Record for 2024-04-16-44
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 995232 DEA: 120U1704 EFIS: 1223000051
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-133,261-9.8/12.6,0.0/3.5
Work Description: COLD PLANE, OVERLAY, AND REFRESH PAVEMENT DELINEATION.
Location Description: ORANGE COUNTY IN IRVINE ON ROUTE 133 FROM TECHNOLOGY DRIVE UNDERCROSSING TO PORTOLA PARKWAY UNDERCROSSING AND ON ROUTE 261 FROM WALNUT AVENUE OVERCROSSING TO 0.6 MILE NORTH OF PORTOLA PARKWAY OVERCROSSING
Contractor Name: CALMEX ENGINEERING INC.
Contractor Address: Unknown
Resident Engineer: Luis Vazquez Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2024-04-16-44
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: 04/16/2024
Date that the sample was received by the laboratory/organization performing the testing: 04/23/2024
The quantity of what the sample constitutes: 4 Bags Of Combined Aggregate
A brief description of the sample: PSUE 1/2" RHMA-G-SP 1.0% LAS
From where was the sample collected: Manufacturer
Laboratory sample identification: 0185G-24
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: AAA-Corona/SJR/Ingevity/Morelife 500
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: AAA-Corona
Where the material sample would have been placed if not sampled: Asphalt Paving
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number: 106836
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
