Sample Record

Owner Lab

  • Sequoia Consultants

DIME Sample ID 2021-05-22-5

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 Date01/09/2023
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 Date05/22/2021 Sample Unique Key5
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 testing03/23/2021
Sample typeQuality Control A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutesBetween 0-100 CY From where was the sample collectedJob Site
First name of sampler or witnessed byErroll Last name of sampler or witnessed byBENTON
Title of samplerMaterials Tester Telephone number of sampler7149746316
Laboratory sample identificationC032221-100 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCemex Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design number1614705
The truck number from where the sample was collected70509 The batch plant ticket number from where the sample was collected29538485
Concrete batch plantCemex Irvine The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedJobsite Where the material sample would have been placed if not sampledretaining wall
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-05-22-5-1CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete CylindersHector Payan, Sequoia Consultants04/19/2021shamila Ranjan
No
Info

Sample File Attachments

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Test File Attachments


DIME Test ID: 2021-05-22-5-1 CTM 521-June 2012