Sample Record for 2024-03-25-44
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 210624 DEA: 120N1404 EFIS: 1213000125
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-57-20.7/21.2
Work Description: SHOULDER WIDENING, MODIFY CURBS, GUTTER, AND DRAINAGE
Location Description: ORANGE COUNTY, IN BREA, FROM LAMBERT ROAD SOUTHBOUND ON RAMP TO 0.2 MILE NORTH OF LAMBERT ROAD UNDERCROSSING
Contractor Name: All American Asphalt
Contractor Address: P.O. Box 2229, Corona CA, 92878
Resident Engineer: Adil Mujtaba Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2024-03-25-44
TL Number from the TL Form: Long Beach
Sample Submitted By Organization: CT D07 - Plant Services
Sample Organization Contact: 562-345-3126
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 03/25/2024
Date that the sample was received by the laboratory/organization performing the testing: 03/25/2024
The quantity of what the sample constitutes: 50 CY
A brief description of the sample: PCC
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Robertson's Pomona
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-33-0061
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: 3/8 inch
The concrete mix design number: SC675B38
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| 2024-03-25-44-1 | CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse Aggregates | 07/02/2024 | 03/25/2024 | David Bassily | CT D07 - Plant Services | | David Bassily |
| 2024-03-25-44-2 | CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse Aggregates | 07/02/2024 | 03/25/2024 | David Bassily | CT D07 - Plant Services | | David Bassily |
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