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Sample Record for 2024-01-18-24

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 213750 DEA: 120K0224 EFIS: 1214000097 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-5-14.5/17.1
Work Description: South County Improvement Project (Phase 2 - Oso/Alicia) CONST BRIDGES, RW, SW, HMA PVMT, JPCP, DRAINAGE, AND ELECT SYSTEMS.
Location Description: ORANGE COUNTY IN MISSION VIEJO AND LAGUNA HILLS FROM 0.7 MILE SOUTH OF OSO PARKWAY OVERCROSSING TO 0.3 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING
Contractor Name: Flatiron West, Inc
Contractor Address: 1770 La Costa Meadows Drive, San Marcos, California 92078
Resident Engineer: Steven Kim Structure Rep.: Sara Soleimani

Sample Information

DIME Sample ID: 2024-01-18-24
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: Concrete
Sample Taken Date: 01/18/2024
Date that the sample was received by the laboratory/organization performing the testing: 01/18/2024
The quantity of what the sample constitutes: 310 CU.YDS
A brief description of the sample: 1", 3/8" & SAND
From where was the sample collected: Manufacturer
Laboratory sample identification: 24-0086
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CEMEX - IRVINE

Material Information

The concrete mix design number: 1605760
The truck number from where the sample was collected: 10067282
The batch plant ticket number from where the sample was collected: 31082664
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: On the belt of the plant
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results