Sample Record for 2023-04-06-10
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214437 DEA: 07323104 EFIS: 0716000061
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-210-R36.0/R40.6
Work Description: PSR-TMDL
Location Description: LOS ANGELES COUNTY IN IRWINDALE AND AZUSA FROM 0.1 MILE EAST HIGHLAND AVENUE UNDERCROSSING TO SOUTH CITRUS AVENUE OVERCROSSING
Contractor Name: Ortiz Enterprises
Contractor Address: 6 Cushing, Suite 200, Irvine , CA 92618
Resident Engineer: Hai Hong Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2023-04-06-10
TL Number from the TL Form:
Sample Submitted By Organization: Sequoia Consultants
Sample Organization Contact: (714) 974-6316
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 04/06/2023
Date that the sample was received by the laboratory/organization performing the testing: 04/06/2023
The quantity of what the sample constitutes: 1
A brief description of the sample: 1
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: 1
Material Information
Source Identification (SMARA, name of Pit or Job Site): 1
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: 1
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1-1/2 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
