Sample Record

Owner Lab

  • Sequoia Consultants

DIME Sample ID 2020-12-15-23

Project Information

Project IdentifiersProject ID: 214909
DEA: 120N8604
EFIS: 1214000123
DIST-CO-RTE-PM12-ORA-73-23.7/24.1
Award Date06/25/2020
Closeout DateNot set
Work DescriptionREPLACE STRUCTURAL CONCRETE BRIDGE & RETAINING WALL; & PLACE HMA.
Location DescriptionORANGE COUNTY IN NEWPORT BEACH FROM 0.3 MILE NORTH OF BISON AVENUE TO 0.3 MILE SOUTH OF UNIVERSITY DRIVE
QA Service Level1 (Verified on 07/21/2020)

Sample Information

Sample Taken Date12/15/2020 Sample Unique Key23
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 testing12/26/2020
Sample typeQuality Control A brief description of the samplestructural concrete
The quantity of what the sample constitutesOne Sample Every 100 CY From where was the sample collectedJob Site
First name of sampler or witnessed byKristi Last name of sampler or witnessed byDoss
Title of samplerMrs Telephone number of sampler7149746316
Laboratory sample identificationC121520-104 Linked DIME Sample ID-
The fabricator/manufacturer/facility nameCemex Transportation Laboratory (TL) Number-
Inspector Lot Number from the Transportation Laboratory (TL) Form- Structure unique identifier12-0N8604
Structure name12-0N8604 Route 73 in Newport Beach

Material Information

Material TypeConcrete The concrete mix design number1614705
The truck number from where the sample was collected67845 The batch plant ticket number from where the sample was collected29393310
Concrete batch plantirviene The fabricator/manufacturer designation for the sampleMix
A detailed description of where the material sample was collectedon site Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2020-12-15-23-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylindersshamila RanjanSequoia Consultants01/12/2021shamila Ranjan
No
Info