Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2013-10-30-11007779

Project Information

Project IdentifiersProject ID: 7757
DEA: 07252614
EFIS: 0700021271
DIST-CO-RTE-PM07-LA-5-C43.9/C46.4
Award Date12/12/2012
Closeout Date06/02/2015
Work DescriptionREPLACE CONCRETE SLABS WITH PRECAST CONCRETE PANELS.
Location DescriptionLOS ANGELES COUNTY IN AND NEAR LOS ANGELES FROM SAN FERNANDO ROAD OVERHEAD TO 0.2 MILE SOUTH OF WELDON CANYON OVERCROSSING
QA Service Level1 (Verified on 11/12/2012)

Sample Information

Sample Taken Date10/30/2013 Sample Unique Key11007779
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 testing10/31/2013
Sample typeAnnual Source Testing A brief description of the sampleWashed Concrete Sand
The quantity of what the sample constitutes 3 Bags From where was the sample collectedSource
First name of sampler or witnessed byJeff Last name of sampler or witnessed byLopez
Title of samplerQuality Control Manager Telephone number of sampler(951) 634-2002
Laboratory sample identification3261B Linked DIME Sample IDNot set
The fabricator/manufacturer/facility nameCemex Lytle Creek Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)SMARA No. 91-36-0040
The fabricator's/manufacturer's product name for the sampleNot set The fabricator/manufacturer designation for the sampleNot set
The plant numberNot set A detailed description of where the material sample was collectedConveyer Belt
Where the material sample would have been placed if not sampledNot set Primary Aggregate Nominal Sizefine
The concrete mix design number Lot numberNot set
Sublot numberNot set HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2013-10-30-11007779-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesNader RashidiCT - Southern Regional Laboratory11/08/2013Nader Rashidi
Yes
02/28/2014
2013-10-30-11007779-2CTM 207-March 2012: Method of Test for Specific Gravity and Absorption of Fine AggregateNemencio DaofCT - Southern Regional Laboratory11/07/2013Nemencio Daof
Yes
02/28/2014
2013-10-30-11007779-3CTM 213-December 2012: Method of Test for Organic Impurities in Concrete SandNader RashidiCT - Southern Regional Laboratory11/07/2013Nader Rashidi
Yes
02/28/2014
2013-10-30-11007779-4CTM 217-June 2011: Method of Test for Sand EquivalentNemencio DaofCT - Southern Regional Laboratory01/09/2014Nemencio Daof
Yes
02/28/2014
2013-10-30-11007779-5CTM 229-June 2011: Method of Test for Durability IndexNemencio DaofCT - Southern Regional Laboratory11/08/2013Nemencio Daof
Yes
02/28/2014