Sample Record

Owner Lab

  • CT D12 - Huntington Beach Field Laboratory

DIME Sample ID 2022-10-28-1

Project Information

Project IdentifiersProject ID: 213750
DEA: 120K0224
EFIS: 1214000097
DIST-CO-RTE-PM12-ORA-5-14.5/17.1
Award Date03/05/2019
Closeout DateNot set
Work DescriptionSouth County Improvement Project (Phase 2 - Oso/Alicia) CONST BRIDGES, RW, SW, HMA PVMT, JPCP, DRAINAGE, AND ELECT SYSTEMS.
Location DescriptionORANGE COUNTY IN MISSION VIEJO AND LAGUNA HILLS FROM 0.7 MILE SOUTH OF OSO PARKWAY OVERCROSSING TO 0.3 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING
QA Service Level1 (Verified on 04/15/2019)

Sample Information

Sample Taken Date10/28/2022 Sample Unique Key1
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 testing10/28/2022
Sample typeQuality Assurance A brief description of the sampleCoarse PCC Aggregate
The quantity of what the sample constitutes333 cu. Yds. From where was the sample collectedManufacturer
First name of sampler or witnessed byJohnny Last name of sampler or witnessed byDo
Title of sampler Telephone number of sampler714-306-6148
Laboratory sample identification22-1092 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCemex Irvine 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 number1614705
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected41980475
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedAt the Cemex Plant Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments