Sample Record
Owner Lab
- CT D12 - Huntington Beach Field Laboratory
DIME Sample ID 2025-09-22-67
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Project Information
| Project Identifiers | Project ID: 1000416 DEA: 120S1104 EFIS: 1219000091 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-22-R0.9/R9.4 |
| Award Date | 09/04/2024 |
| Closeout Date | Not set |
| Work Description | REPLACE CONCRETE BARRIER AND MODIFY LIGHTING SYSTEM. |
| Location Description | ORANGE FROM BOLSA CHICA ROAD OVERCROSSING IN GARDEN GROVE TO LEWIS STREET OVERCROSSING IN ORANGE |
| QA Service Level | 1 (Verified on 08/05/2024) |
Sample Information
| Sample Taken Date | 09/22/2025 | Sample Unique Key | 67 |
|---|---|---|---|
| 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 testing | 09/23/2025 |
| Sample type | Quality Assurance | A brief description of the sample | 4x8 concrete cylinders |
| The quantity of what the sample constitutes | 6 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Brandon | Last name of sampler or witnessed by | Tom |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 25-0334 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | National / Artesia | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | A59C456T10 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 2000053 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Discharge from concrete truck into wheelbarrow. | Where the material sample would have been placed if not sampled | 60 MA 257+60 to 259+61 N.R.M. Artesia |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
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