Sample Record
Owner Lab
- CT D12 - Huntington Beach Field Laboratory
DIME Sample ID 2023-12-27-20
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 993870 DEA: 120R5604 EFIS: 1218000117 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-5,55,73,91,133,405-var |
| Award Date | 04/12/2023 |
| Closeout Date | Not set |
| Work Description | PLACE RHMA-G, HMA, SLAB REPLACEMENT AND JPCP. |
| Location Description | ORANGE COUNTY AT VARIOUS LOCATIONS |
| QA Service Level | 1 (Verified on 06/14/2022) |
Sample Information
| Sample Taken Date | 12/27/2023 | Sample Unique Key | 20 |
|---|---|---|---|
| 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 | 12/28/2023 |
| Sample type | Quality Assurance | A brief description of the sample | Concrete beams |
| The quantity of what the sample constitutes | 3 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Kenny | Last name of sampler or witnessed by | Do |
| Title of sampler | Telephone number of sampler | 9498727223 | |
| Laboratory sample identification | 23-0417 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Security Paving | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | G3-23-PCC-345-HE |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 1 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Concrete from wheelbarrow | Where the material sample would have been placed if not sampled | sta 28 94 to sta 42 00 |
| From Lot No. | Bag Lot No. |
Submitted Tests
Test File Attachments
DIME Test ID: 2023-12-27-20-1 CTM 524-March 2013 (Verified)
DIME Test ID: 2023-12-27-20-2 CTM 521-June 2020 (Verified)