Sample Record for 2024-07-24-20
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994582 DEA: 073203U4 EFIS: 0722000071
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-91,605-R16.6/R16.8,R0.0/R10.4
Work Description: PLACE CONCRETE PAVEMENT AND HIGH FRICTION SURFACE TREATMENT.
Location Description: LOS ANGELES COUNTY ON ROUTE 605 FROM 0.2 MILE NORTH OF KATELLA AVENUE UNDECROSSING TO 0.1 MILE NORTH OF TELEGRAPH ROAD UNDERCROSSING AND ON ROUTE 91 FROM 0.4 MILE WEST OF ROUTE 605 UNDERCROSSING TO 0.2 MILE WEST OF ROUTE 605 UNDERCROSSING
Contractor Name: RASMUSSEN/VANGUARD
Contractor Address: 28548 LIVINGSTON AVENUE, VALENCIA CA 91335
Resident Engineer: Martin Oregel Structure Rep.: Tien Chu
Sample Information
DIME Sample ID: 2024-07-24-20
TL Number from the TL Form: C006817
Sample Submitted By Organization: CT D07 - Plant Services
Sample Organization Contact: 562-345-3126
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 07/24/2024
Date that the sample was received by the laboratory/organization performing the testing: 07/25/2024
The quantity of what the sample constitutes: 750 Tons
A brief description of the sample: 3/4 AC Aggregate
From where was the sample collected: Manufacturer
Laboratory sample identification: 033
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Materials Co.-Irwindale
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-19-0035
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: Cold Feed
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
