Sample Record

Owner Lab

  • CT D12 - Huntington Beach Field Laboratory

DIME Sample ID 2022-10-28-12

Project Information

Project IdentifiersProject ID: 214951
DEA: 120K0234
EFIS: 1214000100
DIST-CO-RTE-PM12-ORA-5-17.1/18.9
Award Date09/23/2020
Closeout DateNot set
Work DescriptionSouth County Improvement Project (Phase 3 - El Toro/Alicia) WIDEN FREEWAY AND BRIDGES, RECONSTRUCT BRIDGE AND WALLS.
Location DescriptionORANGE COUNTY IN MISSION VIEJO, LAGUNA HILLS, LAGUNA WOODS AND LAKE FOREST FROM 0.4 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING TO 0.2 MILE NORTH OF EL TORO ROAD UNDERCROSSING
QA Service Level1 (Verified on 10/01/2020)

Sample Information

Sample Taken Date10/28/2022 Sample Unique Key12
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 samplePCC
The quantity of what the sample constitutes60 Cu.yd From where was the sample collectedManufacturer
First name of sampler or witnessed byJohnny Cuong Last name of sampler or witnessed byDo
Title of sampler Telephone number of sampler
Laboratory sample identification22-1106 Linked DIME Sample ID
The fabricator/manufacturer/facility nameHolliday Rock 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 number3F36L005
The truck number from where the sample was collected The batch plant ticket number from where the sample was collectedR108169346
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedOn the belt of the plant 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
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Sample File Attachments

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Test File Attachments