Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2019-11-22-15

Project Information

Project IdentifiersProject ID: 212888
DEA: 07202124
EFIS: 0700020870
DIST-CO-RTE-PM07-LA-710-20.9/24.6
Award Date02/16/2018
Closeout DateNot set
Work DescriptionPAVEMENT REHABILITATION AND BRIDGE WIDENING
Location DescriptionLOS ANGELES COUNTY IN AND NEAR BELL, VERNON, AND CITY OF COMMERCE, FROM 0.2 MILE SOUTH OF SLAUSON AVENUE OVERCROSSING TO 0.1 MILE NORTH OF THIRD STREET OVERCROSSING
QA Service Level1 (Verified on 03/29/2018)

Sample Information

Sample Taken Date11/22/2019 Sample Unique Key15
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing11/23/2019
Sample typeAcceptance A brief description of the sample1" x No. 4 PCC AGGREGATE
The quantity of what the sample constitutes1 BAG From where was the sample collectedDistributor
First name of sampler or witnessed byHORNESTO Last name of sampler or witnessed byCASTILLO
Title of samplerMREA Telephone number of sampler
Laboratory sample identification8916 Linked DIME Sample ID2019-11-22-15
The fabricator/manufacturer/facility nameNATIONAL READY MIXED CONCRETE VERNON PLANT Transportation Laboratory (TL) NumberC915098
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)Unknown
The fabricator's/manufacturer's product name for the sampleUnknown The fabricator/manufacturer designation for the sampleOLYMPIC DECK REPAIR
The plant numberUnknown A detailed description of where the material sample was collectedunknown
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size1 inch
The concrete mix design numberUnknown Lot numberUnknown
Sublot numberUnknown HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2019-11-22-15-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesEDMOND JABBOURCT - Southern Regional Laboratory11/25/2019Jose Mendez
No
Info
2019-11-22-15-2CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)EDMOND JABBOURCT - Southern Regional Laboratory11/27/2019Jose Mendez
No
Info