Sample Record

Owner Lab

  • CEMEX - Central & Southern California

DIME Sample ID 2019-05-08-10

Project Information

Project IdentifiersProject ID: 213750
DEA: 120K0224
EFIS: 1214000097
DIST-CO-RTE-PM12-ORA-5-14.5/17.1
Award Date03/05/2019
Closeout DateNot set
Work DescriptionSouth County Improvement Project (Phase 2 - Oso/Alicia) CONST BRIDGES, RW, SW, HMA PVMT, JPCP, DRAINAGE, AND ELECT SYSTEMS.
Location DescriptionORANGE 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
QA Service Level1 (Verified on 04/15/2019)

Sample Information

Sample Taken Date05/08/2019 Sample Unique Key10
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testingNot set
Sample typeAnnual Source Testing A brief description of the sample1 x 4 PCC Aggregate
The quantity of what the sample constitutes1 of 4 From where was the sample collectedSource
First name of sampler or witnessed byAlbert Last name of sampler or witnessed bySegura
Title of samplerQC Lead Technician Telephone number of sampler(909) 436- 8680
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCemex Lytle Creek Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-36-0040::LYTLE CREEK
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 collectedPlant Stockpile
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1 inch
The concrete mix design number Lot number
Sublot number Aggregate Mix NumberNot set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments