Sample Record for 2023-03-17-53
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 209698 DEA: 072332E4 EFIS: 0700000391 COOP: 0705187
QA Service Level: 2
DIST-CO-RTE-PM: 07-LA-I-5-45.4/54
Work Description: Addition of 14 miles of HOV lanes in both directions would extend existing carpool lanes on the I- 5 in San Fernando Valley to Santa Clarita Valley
Location Description: The I-5 North Capacity Enhancements Project focuses on improvements to the I-5 freeway from cities of Santa Clarita and Castaic, beginning at the SR-14 interchange to Parker Rd.
Contractor Name: Not yet Awarded
Contractor Address: Unknown
Resident Engineer: Emile Eid Structure Rep.: Chanh Tong
Sample Information
DIME Sample ID: 2023-03-17-53
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: 03/17/2023
Date that the sample was received by the laboratory/organization performing the testing: 03/17/2023
The quantity of what the sample constitutes: 1 per batch
A brief description of the sample: 1x4 concrete aggs
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: National RM
Material Information
Source Identification (SMARA, name of Pit or Job Site): NA
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: belt cut
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
