Sample Record for 2024-07-08-89
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 993446 DEA: 120J34U4 EFIS: 1218000034
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-55,55-29.6,R6.4/10.3
Work Description: CONSTR BRIDGES, RW, SW, JPCP, HMA PVMT, DRAINAGE AND ELECT SYSTEMS.
Location Description: ORANGE COUNTY IN IRVINE, SANTA ANA, AND TUSTIN ON ROUTE 5 AT NEWPORT AVENUE UNDERCROSSING AND ON ROUTE 55 FROM 0.4 MILE NORTH OF ROUTE 55/405 SEPARATION TO 0.1 MILE SOUTH OF ROUTE 5/55 SEPARATION
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 Townsgate Road, Suite 200, Westlake Village, CA 91361
Resident Engineer: Adrian Wu Structure Rep.: Yong Gyun Park
Sample Information
DIME Sample ID: 2024-07-08-89
TL Number from the TL Form: Unknown
Sample Submitted By Organization: G3 Quality, Incorporated - Cerritos
Sample Organization Contact: (562) 321-9840
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 07/08/2024
Date that the sample was received by the laboratory/organization performing the testing: 07/09/2024
The quantity of what the sample constitutes: 1 Bag
A brief description of the sample: 3/8", WCS
From where was the sample collected: Job Site
Laboratory sample identification: Mix S85C440T11, Set 1
Structure unique identifier: 00-0000
Structure name:
The fabricator/manufacturer/facility name: National Ready Mix - Irwindale
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-19-0052
The fabricator's/manufacturer's product name for the sample: Set 1
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Belt Cut
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 3/8 inch
The concrete mix design number: S85C440T11
Lot number: 1
Sublot number: 1
Aggregate Mix Number:
Test Results
