Sample Record

Owner Lab

  • Coreslab

DIME Sample ID 2021-04-22-41

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 Date04/22/2021 Sample Unique Key41
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 testing04/22/2021
Sample typeQuality Control A brief description of the sampleConcrete
The quantity of what the sample constitutes34 CY From where was the sample collectedManufacturer
First name of sampler or witnessed byAugusto Last name of sampler or witnessed byRios, Jr.
Title of samplerQC Inspector Technician Telephone number of sampler
Laboratory sample identification125 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCoreslab Structures L.A., Inc. 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 number212
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected78442 78443
Concrete batch plantCoreslab The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedFront Discharge Ready Mix Truck Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.

Sample File Attachments

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Test File Attachments