Sample Record
Owner Lab
- CT D12 - Huntington Beach Field Laboratory
DIME Sample ID 2026-04-14-22
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Project Information
| Project Identifiers | Project ID: 1000611 DEA: 120R32U4 EFIS: 1222000054 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-55-0.2/R17.8 |
| Award Date | 02/07/2025 |
| Closeout Date | Not set |
| Work Description | COLD PLANE, PLACE RHMA, REPLACE CB, SIGNS AND MODIFY LIGHTING SYSTEM. |
| Location Description | ORANGE COUNTY FROM 0.1 MILE SOUTH OF ROUTE 55/1 SEPARATION IN NEWPORT BEACH TO ROUTE 55/91 SEPARATION IN ANAHEIM |
| QA Service Level | 1 (Verified on 09/30/2024) |
Sample Information
| Sample Taken Date | 04/14/2026 | Sample Unique Key | 22 |
|---|---|---|---|
| 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 | 04/15/2026 |
| Sample type | Quality Assurance | A brief description of the sample | Concrete beams |
| The quantity of what the sample constitutes | 6 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | MB Pro | Last name of sampler or witnessed by | MB PRO |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 26-0067 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | SHORTLOAD CONCRETE INC | 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 | CTS-65-EHI |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | Unknown | |
| 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 | Inside Lanes NB/SB 55. 1016+00~1041+00 |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||