Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2019-12-13-13

Project Information

Project IdentifiersProject ID: 211260
DEA: 072159U4
EFIS: 0715000160
DIST-CO-RTE-PM07-LA,ORA-5-0.0/1.5, 44.3/44.4
Award Date05/27/2016
Closeout Date08/01/2023
Work DescriptionCONSTRUCT HOV LANES AND MIX FLOW LANES.
Location DescriptionLOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
QA Service Level1 (Verified on 03/16/2016)

Sample Information

Sample Taken Date12/13/2019 Sample Unique Key13
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 testing12/17/2019
Sample typeAcceptance A brief description of the sample1" X No. 4 PCC AGGREGATE
The quantity of what the sample constitutes1 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 identification9002 Linked DIME Sample ID2019-12-13-13
The fabricator/manufacturer/facility nameHANSON EAGEL VALLEY Transportation Laboratory (TL) NumberC914416
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)Unknown
The fabricator's/manufacturer's product name for the sampleUnknown The fabricator/manufacturer designation for the sampleSECURITY PAVEMENT LA MIRADA
The plant numberUnknown A detailed description of where the material sample was collectedSECURITY PAVEMENT PORTABLE PALNT LA MERIDA
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 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