Sample Record

Owner Labs

  • CT D07 - Plant Services
  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2022-04-19-56

Project Information

Project IdentifiersProject ID: 211260
DEA: 072159U4
EFIS: 0715000160
DIST-CO-RTE-PM07-LA,ORA-5-0.0/1.5, 44.3/44.4
Award Date05/27/2016
Closeout DateNot set
Work DescriptionCONSTRUCT HOV LANES AND MIX FLOW LANES.
Location DescriptionLOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
QA Service Level1 (Verified on 03/16/2016)

Sample Information

Sample Taken Date04/19/2022 Sample Unique Key56
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing04/20/2022
Sample typeAcceptance A brief description of the sampleCoarse and fine aggregate
The quantity of what the sample constitutesThree Bags From where was the sample collectedManufacturer
First name of sampler or witnessed byBaher Last name of sampler or witnessed byFakhoury
Title of sampler Telephone number of sampler2137937180
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameSecurity Paving batch plant Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-19-0025
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedConveyor Belt
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/8 inch
The concrete mix design numberG3-19-PCC-001 Lot number
Sublot number HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2022-04-19-56-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesBaher FakhouryCT D07 - Plant Services05/02/2022Baher Fakhoury
Yes
06/02/2022Sample # 1 was taken @ 200 CY at 8:00 am
2022-04-19-56-2CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)Baher FakhouryCT D07 - Plant Services05/02/2022Baher Fakhoury
Yes
06/02/2022Sample # 1 was taken @ 200 CY at 8:00 am

Sample File Attachments

File NameExtensionDate UploadedActions
No results found.

Test File Attachments


DIME Test ID: 2022-04-19-56-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2022-04-19-56-2 CTM 227-December 2014 (Verified)