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Sample Record for 2019-12-13-13

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

Project Information

Project ID: 211260 DEA: 072159U4 EFIS: 0715000160 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,ORA-5-0.0/1.5, 44.3/44.4
Work Description: CONSTRUCT HOV LANES AND MIX FLOW LANES.
Location Description: LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 TOWNSGATE RD. SUITE 200, WESTLAKE VILLAGE, CA 91361
Resident Engineer: George Saker Structure Rep.: Lalonde, Danny

Sample Information

DIME Sample ID: 2019-12-13-13
TL Number from the TL Form: C914416
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 12/13/2019
Date that the sample was received by the laboratory/organization performing the testing: 12/17/2019
The quantity of what the sample constitutes: 1
A brief description of the sample: 1" X No. 4 PCC AGGREGATE
From where was the sample collected: Distributor
Laboratory sample identification: 9002
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: HANSON EAGEL VALLEY

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: SECURITY PAVEMENT LA MIRADA
The plant number: Unknown
A detailed description of where the material sample was collected: SECURITY PAVEMENT PORTABLE PALNT LA MERIDA
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 1 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.