Sample Record

Owner Lab

  • Sequoia Consultants

DIME Sample ID 2021-02-18-14

Project Information

Project IdentifiersProject ID: 214355
DEA: 120K0214
EFIS: 1214000096
DIST-CO-RTE-PM12-ORA-5-12.4/14.5
Award Date12/20/2019
Closeout Date10/02/2025
Work DescriptionSouth County Improvement Project (Phase 1 - Avery/Crown Valley) PLACE HMA, INSTALL CONC PAVEMENT, RETAIN WALL, MODIFY ELECT SYS. | Add one lane btwn 73 & Oso PKWY
Location DescriptionORANGE COUNTY IN SAN JUAN CAPISTRANO, LAGUNA HILLS, LAGUNA NIGUEL AND MISSION VIEJO FROM 0.5 MILE SOUTH OF AVERY PARKWAY UNDERCROSSING TO 0.8 MILE NORTH OF CROWN VALLEY PARKWAY OVERCROSSING
QA Service Level1 (Verified on 10/31/2019)

Sample Information

Sample Taken Date02/18/2021 Sample Unique Key14
Date that the sample was received by the laboratory/organization performing the testing02/19/2021 Sample typeQuality Control
A brief description of the sample6x12 concrete cylinders The quantity of what the sample constitutes100CY
From where was the sample collectedJob Site First name of sampler or witnessed byDerek
Last name of sampler or witnessed byBezotte Title of samplerField Technician
Telephone number of sampler Laboratory sample identificationC021821-102
Linked DIME Sample ID The fabricator/manufacturer/facility nameCemex San Juan Capistrano
Transportation Laboratory (TL) Number Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier Structure nameRetaining Wall 715
Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design number1614705
The truck number from where the sample was collected10070509 The batch plant ticket number from where the sample was collected29482978
Concrete batch plantCemex San Juan Capistrano The fabricator/manufacturer designation for the sampleMix
A detailed description of where the material sample was collectedDischarge chute from back of truck Where the material sample would have been placed if not sampledRetaining Wall 715
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedDate AddedVerified?Release DateTest CommentsPrivacy LevelActions
2021-02-18-14-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersHector Payan, Sequoia Consultants02/25/2021
No

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Test File Attachments


DIME Test ID: 2021-02-18-14-1 CTM 521-June 2020