Sample Record
Owner Lab
- Sequoia Consultants
DIME Sample ID 2021-04-07-16
Project Information
Project Identifiers | Project ID: 214355 DEA: 120K0214 EFIS: 1214000096 |
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DIST-CO-RTE-PM | 12-ORA-5-12.4/14.5 |
Award Date | 12/20/2019 |
Closeout Date | Not set |
Work Description | South County Improvement Project (Phase 1 - Avery/Crown Valley) PLACE HMA, INSTALL CONC PAVEMENT, RETAIN WALL, MODIFY ELECT SYS. | Add one lane btwn 73 & Oso PKWY |
Location Description | ORANGE COUNTY IN SAN JUAN CAPISTRANO, LAGUNA HILLS, LAGUNA NIGUEL AND MISSION VIEJO FROM 0.5 MILE SOUTH OF AVERY PARKWAY UNDERCROSSING TO 0.8 MILE NORTH OF CROWN VALLEY PARKWAY OVERCROSSING |
QA Service Level | 1 (Verified on 10/31/2019) |
Sample Information
Sample Taken Date | 04/07/2021 | Sample Unique Key | 16 |
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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 testing | 04/08/2021 |
Sample type | Quality Control | A brief description of the sample | 6x12 concrete cylinders |
The quantity of what the sample constitutes | 100CYDS | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Ernie | Last name of sampler or witnessed by | Manzon |
Title of sampler | Field Technician | Telephone number of sampler | |
Laboratory sample identification | C040721-100 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | Cemex San Juan Capistrano | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name | Retaining Wall 715 |
Material Information
Material Type | Concrete | The concrete mix design number | 1614705 |
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The truck number from where the sample was collected | 10070509 | The batch plant ticket number from where the sample was collected | 29566841 |
Concrete batch plant | Cemex San Juan Capistrano | The fabricator/manufacturer designation for the sample | Mix |
A detailed description of where the material sample was collected | Discharge chute from back of truck | Where the material sample would have been placed if not sampled | Retaining Wall |
From Lot No. | Bag Lot No. |
Submitted Tests
DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
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2021-04-07-16-1 | CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders | Ruben Jimenez, Sequoia Consultants | 04/14/2021 | Ken Mancebo | No | Info |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2021-04-07-16-1 CTM 521-June 2020