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Sample Record for 2019-06-11-9

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 213388 DEA: 120N3004 EFIS: 1213000194 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-241-18.3/18.7
Work Description: RAMP REALIGNMENT, PAVING, AND RE-STRIPING.
Location Description: ORANGE COUNTY IN RANCHO SANTA MARGARITA FROM 0.2 MILE SOUTH TO 0.2 MILE NORTH OF SANTA MARGARITA PARKWAY OVERCROSSING
Contractor Name: Beador Const. Co. Inc.
Contractor Address: 26320 LESTER CIRCLE, CORONA CA 92883
Resident Engineer: Nabil Ruda Structure Rep.: Mohammad Rousta

Sample Information

DIME Sample ID: 2019-06-11-9
TL Number from the TL Form:
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Per Request
Type of Material: Aggregate
Sample Taken Date: 06/11/2019
Date that the sample was received by the laboratory/organization performing the testing: 06/11/2019
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: Class 2 AB
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Caltrans

Material Information

Source Identification (SMARA or name of Pit): Unknown
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: Unknown
Sublot number: Unknown

Test Results

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.