Sample Record

Owner Lab

  • Sequoia Consultants

DIME Sample ID 2021-11-24-10

Project Information

Project IdentifiersProject ID: 215236
DEA: 081C6804
EFIS: 0812000343
DIST-CO-RTE-PM08-RIV-74,79and371-Varies
Award Date12/29/2020
Closeout DateNot set
Work DescriptionREPLACE STRUCTURAL CONCRETE BRIDGE, RETAINING WALL AND BOX CULVERT.
Location DescriptionRIVERSIDE COUNTY AT VARIOUS LOCATIONS
QA Service Level1 (Verified on 03/02/2021)

Sample Information

Sample Taken Date11/24/2021 Sample Unique Key10
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 testing11/24/2021
Sample typeQuality Control A brief description of the sampleconcrete aggregates
The quantity of what the sample constitutes1 days production From where was the sample collectedManufacturer
First name of sampler or witnessed byRandy Last name of sampler or witnessed byBlack
Title of samplerField Technician Telephone number of sampler
Laboratory sample identificationOR21-1015 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCemex Perris Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameType 85 Barrier

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 The fabricator/manufacturer designation for the samplemix
The plant numberPerris A detailed description of where the material sample was collectedConveyor Belt
Where the material sample would have been placed if not sampledbarrier Primary Aggregate Nominal Size1 inch
The concrete mix design number1610974 Lot number
Sublot number Aggregate Mix NumberNot set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-11-24-10-1CTM 217-June 2011: Method of Test for Sand EquivalentRuben Jimenez, Sequoia Consultants11/24/2021Ken Mancebo
No
Info

Sample File Attachments

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Test File Attachments


DIME Test ID: 2021-11-24-10-1 CTM 217-June 2011