Sample Record for 2023-04-03-34
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994267 DEA: 07326204 EFIS: 0716000113
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-39-17.8
Work Description: CONSTRUCT BRIDGE, PLACE STRUCTURAL STEEL AND CONCRETE BARRIER.
Location Description: LOS ANGELES COUNTY IN AZUSA AT SAN GABRIEL RIVER BRIDGE
Contractor Name: FEC Future Contractors & Engineers, Inc
Contractor Address: 184 Technology Dr., Ste 2, Irvine, CA 92618
Resident Engineer: Joe Doughly Structure Rep.: Hadi Moradi
Sample Information
DIME Sample ID: 2023-04-03-34
TL Number from the TL Form: C006658
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: 04/03/2023
Date that the sample was received by the laboratory/organization performing the testing: 04/04/2023
The quantity of what the sample constitutes: 140 tons
A brief description of the sample: 3/4 AC Aggregate
From where was the sample collected: Manufacturer
Laboratory sample identification: 010
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Materials Company Sun Valley
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-19-0035
The fabricator's/manufacturer's product name for the sample: 3/4 HMA Type A
The fabricator/manufacturer designation for the sample: Mix 220826
The plant number: Sun Valley
A detailed description of where the material sample was collected: Storage Bin
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
