Sample Record

Owner Lab

  • Alta Vista Solutions - Whittier

DIME Sample ID 2025-04-29-65

Project Information

Project IdentifiersProject ID: 995085
DEA: 07322904
EFIS: 0716000059
DIST-CO-RTE-PM07-LA-27-0.0/18.6
Award Date11/06/2023
Closeout DateNot set
Work DescriptionREMOVE EXISTING AC PAVEMENT & HMA OVERLAY.
Location DescriptionLOS ANGELES COUNTY IN AND NEAR LOS ANGELES FROM ROUTE 1 TO DEVONSHIRE STREET
QA Service Level1 (Verified on 09/11/2023)

Sample Information

Sample Taken Date04/29/2025 Sample Unique Key65
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing04/29/2025
Sample typeQuality Assurance A brief description of the sample6X12 cylinders
The quantity of what the sample constitutes10 Cy From where was the sample collectedJob Site
First name of sampler or witnessed byManuel Last name of sampler or witnessed byUy
Title of samplerMaterials Tester Telephone number of sampler9495016042
Laboratory sample identification25-1376-1377-1378 Linked DIME Sample ID
The fabricator/manufacturer/facility nameN/A Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name(Curb Ramp No. 79, 80, 83 and 84). Sample at off ramp curb # 84 Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design number830C396L0A
The truck number from where the sample was collectedTruck or Ticket 208032 The batch plant ticket number from where the sample was collectedLoad 1
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedJobsite Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

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