Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2021-07-22-17
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Project Information
| Project Identifiers | Project ID: 214951 DEA: 120K0234 EFIS: 1214000100 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-5-17.1/18.9 |
| Award Date | 09/23/2020 |
| Closeout Date | Not set |
| Work Description | South County Improvement Project (Phase 3 - El Toro/Alicia) WIDEN FREEWAY AND BRIDGES, RECONSTRUCT BRIDGE AND WALLS. |
| Location Description | ORANGE COUNTY IN MISSION VIEJO, LAGUNA HILLS, LAGUNA WOODS AND LAKE FOREST FROM 0.4 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING TO 0.2 MILE NORTH OF EL TORO ROAD UNDERCROSSING |
| QA Service Level | 1 (Verified on 10/01/2020) |
Sample Information
| Sample Taken Date | 07/22/2021 | Sample Unique Key | 17 |
|---|---|---|---|
| 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 | 07/26/2021 |
| Sample type | Quality Assurance | A brief description of the sample | (2) 6"x12" Cylinders |
| The quantity of what the sample constitutes | (2) 6"x12" Cylinders | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Paul | Last name of sampler or witnessed by | Shrestha |
| Title of sampler | Inspector | Telephone number of sampler | 4242987781 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Con-Fab California, LLC | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L108-006-21 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | SCC S9 8 0F |
|---|---|---|---|
| The truck number from where the sample was collected | 121 | The batch plant ticket number from where the sample was collected | 1450 |
| Concrete batch plant | SPC onsite batch plant | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | At pour location | Where the material sample would have been placed if not sampled | Girder |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-07-22-17-1 ASTM C39-18 (Verified)