Sample Record

Owner Lab

  • CT D12 - Huntington Beach Field Laboratory

DIME Sample ID 2022-10-19-13

Project Information

Project IdentifiersProject ID: 213749
DEA: 120C1104
EFIS: 1200000633
DIST-CO-RTE-PM12-ORA-57-20.3/21.6
Award Date04/19/2019
Closeout Date05/28/2024
Work DescriptionSR-57 Lambert Interchange Project: WIDEN BRIDGES AND CONSTRUCT RW, SW, HMA, JPCP AND ELECTRICAL SYSTEMS.
Location DescriptionORANGE COUNTY IN BREA FROM 0.6 MILE SOUTH TO 0.7 MILE NORTH OF LAMBERT ROAD UNDERCROSSING
QA Service Level1 (Verified on 05/31/2019)

Sample Information

Sample Taken Date10/19/2022 Sample Unique Key13
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 testing10/19/2022
Sample typeQuality Assurance A brief description of the sample EB Lambert NB57 loop on ramp North of Bridge-Replacement panels
The quantity of what the sample constitutes140CY From where was the sample collectedManufacturer
First name of sampler or witnessed byJIMMY CUONG Last name of sampler or witnessed byPHAM
Title of sampler Telephone number of sampler
Laboratory sample identification22-1060 Linked DIME Sample ID
The fabricator/manufacturer/facility nameSECURITY PAVING - LA MIRADA Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberG3-19-PCC-001
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected204986
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedStockpile Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.

Sample File Attachments

File NameExtensionDate UploadedActions
22-1060pdf10/20/2022   Info

Test File Attachments