Sample Record for 2022-08-25-78
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214951 DEA: 120K0234 EFIS: 1214000100
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-5-17.1/18.9
Work Description: South County Improvement Project (Phase 3 - El Toro/Alicia) WIDEN FREEWAY AND BRIDGES, RECONSTRUCT BRIDGE AND WALLS.
Location Description: ORANGE COUNTY IN MISSION VIEJO, LAGUNA HILLS, LAGUNA WOODS AND LAKE FOREST FROM 0.4 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING TO 0.2 MILE NORTH OF EL TORO ROAD UNDERCROSSING
Contractor Name: GUY F. ATKINSON CONSTRUCTION, LLC
Contractor Address: 18201 Von Karman Ave #800, Irvine, CA 92612
Resident Engineer: Irvin Nguyen Structure Rep.: Jason Kim
Sample Information
DIME Sample ID: 2022-08-25-78
TL Number from the TL Form:
Sample Submitted By Organization: CT D12 - Huntington Beach Field Laboratory
Sample Organization Contact: 9492798846
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 08/25/2022
Date that the sample was received by the laboratory/organization performing the testing: 08/25/2022
The quantity of what the sample constitutes: 18 CY
A brief description of the sample: Rock and sand.
From where was the sample collected: Manufacturer
Laboratory sample identification: 22-0781
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Robertson's Ready-Mix Irvine
Material Information
Source Identification (SMARA, name of Pit or Job Site): Robertsons Corona 91-33-0061
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: 3/8 inch
The concrete mix design number: RRM20147
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
