Sample Record for 2019-01-23-7
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 212910 DEA: 080K2914 EFIS: 0812000098
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-10-30.9/33.3
Work Description: LANE REPLACEMENT
Location Description: SAN BERNARDINO COUNTY IN REDLANDS FROM ORANGE STREET UNDERCROSSING TO REDLANDS BLVD OFF-RAMP UNDERCROSSING
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 13170 TELFAIR AVENUE, SYLMAR, CA 91342
Resident Engineer: Nick Truong Structure Rep.: Ali El-Zaynab
Sample Information
DIME Sample ID: 2019-01-23-7
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 01/23/2019
Date that the sample was received by the laboratory/organization performing the testing: 02/05/2019
The quantity of what the sample constitutes: 1 Bag
A brief description of the sample: Class 2 Aggregate Base
From where was the sample collected: Job Site
Laboratory sample identification: 8493
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: caltrans
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-19-0033::PALMDALE
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Unknown
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: Unknown
Lot number: 1
Sublot number: 1
Aggregate Mix Number:
Test Results
