Sample Record

Owner Lab

  • CT D07 - Plant Services

DIME Sample ID 2022-08-01-10

Project Information

Project IdentifiersProject ID: 212085
DEA: 07296604
EFIS: 0713000057
DIST-CO-RTE-PM07-LA-10-14.0/19.0
Award Date06/04/2018
Closeout Date05/04/2023
Work DescriptionPAINT AND REHABILITATE BRIDGE - (STRAIN (PAINT AND INSTALL CATWALK)
Location DescriptionIN THE CITY OF LOS ANGELES, AT SANTA MONICA VIADUCT (BR. NO. 53-1301). PAINT AND REHABILITATE BRIDGE
QA Service Level1 (Verified on 07/25/2018)

Sample Information

Sample Taken Date08/01/2022 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 testing08/01/2022
Sample typeDepartment Acceptance A brief description of the samplePCC Aggregate
The quantity of what the sample constitutes3 Bags of Aggs From where was the sample collectedSource
First name of sampler or witnessed byAvo Last name of sampler or witnessed byKarajian
Title of samplerTET Telephone number of sampler12137986076
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCemex Ready Mix - Inglewood 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, name of Pit or Job Site)91-36-0106
The fabricator's/manufacturer's product name for the sampleCemex White Mtn Victorville The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedStockpile
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/8 inch
The concrete mix design number1612109 Lot number
Sublot number Aggregate Mix NumberNot set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2022-08-01-10-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesAvo Karajian, CT D07 - Plant Services08/01/2022Avo Karajian
Yes
08/16/2022

Sample File Attachments

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Test File Attachments


DIME Test ID: 2022-08-01-10-1 CTM 202-November 2011 (Verified)