Sample Record for 2022-03-25-32
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 215220 DEA: 07210624 EFIS: 0719000068
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,SBD-71-1.8/R4.7&R0.0/R0.2
Work Description: PLACE STRUCTURE CONCRETE RETAINING WALLS & BOX CULVERT AND PLACE JPCP.
Location Description: IN LOS ANGELES AND SAN BERNARDINO COUNTIES IN POMONA AND CHINO HILLS FROM 0.2 MILE SOUTH OF MISSION BOULEVARD OVERCROSSING TO 0.2 MILE OF SAN BERNARDINO COUNTY LINE.
Contractor Name: OHL USA
Contractor Address: 1920 Main Street, Suite 310, Irvine, California 92614
Resident Engineer: Michael Wang Structure Rep.: Amare Tsegie
Sample Information
DIME Sample ID: 2022-03-25-32
TL Number from the TL Form:
Sample Submitted By Organization: CT D07 - Plant Services
Sample Organization Contact: 562-345-3126
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 03/25/2022
Date that the sample was received by the laboratory/organization performing the testing: 03/25/2022
The quantity of what the sample constitutes: 40
A brief description of the sample: 1x4
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: ROBERTSONS POMONA
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-33-0008::CABAZON QUARRY
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:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| 2022-03-25-32-1 | CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse Aggregates | 06/01/2022 | 03/25/2022 | Zaid Hilli | CT D07 - Plant Services | | |
| 2022-03-25-32-2 | CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse Aggregates | 06/01/2022 | Not scheduled | Zaid Hilli | CT D07 - Plant Services | | |
5806258063
