Sample Record

Owner Labs

  • Ninyo & Moore
  • CT D12 - Huntington Beach Field Laboratory

DIME Sample ID 2022-10-29-1

Project Information

Project IdentifiersProject ID: 213749
DEA: 120C1104
EFIS: 1200000633
DIST-CO-RTE-PM12-ORA-57-20.3/21.6
Award Date04/19/2019
Closeout DateNot set
Work DescriptionSR-57 Lambert Interchange Project: WIDEN BRIDGES AND CONSTRUCT RW, SW, HMA, JPCP AND ELECTRICAL SYSTEMS.
Location DescriptionORANGE COUNTY IN BREA FROM 0.6 MILE SOUTH TO 0.7 MILE NORTH OF LAMBERT ROAD UNDERCROSSING
QA Service Level1 (Verified on 05/31/2019)

Sample Information

Sample Taken Date10/29/2022 Sample Unique Key1
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 testingNot set
Sample typeQuality Assurance A brief description of the samplethree quarter inch HMA Type A
The quantity of what the sample constitutes17 boxes of HMA, 4 bags of combined agg, 1 bag of RAP, 2 quarts of binder From where was the sample collectedManufacturer
First name of sampler or witnessed byDavid Last name of sampler or witnessed byNguyen
Title of samplerTET Telephone number of sampler
Laboratory sample identification22-1107 Linked DIME Sample ID
The fabricator/manufacturer/facility nameVulcan Materials - Corona Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeHot Mix Asphalt HMA TypeType A HMA
HMA Grading3/4 inch Lot number
Sublot number HMA Mix Number

Submitted Tests

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