Sample Record

Owner Lab

  • Sequoia Consultants

DIME Sample ID 2021-05-26-22

Project Information

Project IdentifiersProject ID: 214355
DEA: 120K0214
EFIS: 1214000096
DIST-CO-RTE-PM12-ORA-5-12.4/14.5
Award Date12/20/2019
Closeout DateNot set
Work DescriptionSouth 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 DescriptionORANGE 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 Level1 (Verified on 10/31/2019)

Sample Information

Sample Taken Date05/26/2021 Sample Unique Key22
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 testing05/27/2021
Sample typeQuality Control A brief description of the sampleconcrete aggregate
The quantity of what the sample constitutes1 days production From where was the sample collectedManufacturer
First name of sampler or witnessed byFlint Last name of sampler or witnessed byBenton
Title of samplerField Technician Telephone number of sampler
Laboratory sample identificationOR21-0406-052621 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCemex San Juan Capistrano Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameAvery Right Bridge Abutment 1 wall inlet

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-36-0040::LYTLE CREEK
The fabricator's/manufacturer's product name for the sampleStructural Concrete - Corrosive Environment The fabricator/manufacturer designation for the sampleMix
The plant number4488 A detailed description of where the material sample was collectedConveyor Belt
Where the material sample would have been placed if not sampledAvery Bridge Abutment 1 wall inlet Primary Aggregate Nominal Size1 inch
The concrete mix design number1614705 Lot number
Sublot number Aggregate Mix NumberNot set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-05-26-22-1CTM 226-July 2010: Method of Test for Determination of Moisture Content of Soils and Aggregates by Oven DryingRuben Jimenez, Sequoia Consultants05/27/2021Ken Mancebo
No
Info

Sample File Attachments

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Test File Attachments


DIME Test ID: 2021-05-26-22-1 CTM 226-July 2010