Sample Record for 2022-02-12-17
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214671 DEA: 07303904 EFIS: 0714000044
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-10-31.2/37.2
Work Description: LANE REPLACEMENT
Location Description: LOS ANGELES COUNTY IN BALDWIN PARK AND WEST COVINA FROM 0.1 MILE EAST OF THE 10/605 SEPARATION TO 0.3 MILE WEST OF CITRUS STREET OVERCROSSING
Contractor Name: Sierra Landscape Development Inc.
Contractor Address: 2209 1/2 Chico Ave., South El Monte CA, 91733
Resident Engineer: Hai Hong Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2022-02-12-17
TL Number from the TL Form:
Sample Submitted By Organization: CT D07 - Plant Services
Sample Organization Contact: 562-345-3126
Type of Sample: Department Acceptance
Type of Material: Aggregate
Sample Taken Date: 02/12/2022
Date that the sample was received by the laboratory/organization performing the testing: 02/17/2022
The quantity of what the sample constitutes: Two Samples Each Sample Three Bags
A brief description of the sample: Coarse and fine aggregate
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan/Durbin Irwindale
Material Information
Source Identification (SMARA, name of Pit or Job Site): Vulcan Irwindale, Reliance Irwindale
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Conveyor Belt
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number: G3-21-PRS-237
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
