Sample Record
Owner Lab
- CT D12 - Huntington Beach Field Laboratory
DIME Sample ID 2022-08-26-83
Project Information
Project Identifiers | Project ID: 214355 DEA: 120K0214 EFIS: 1214000096 |
---|---|
DIST-CO-RTE-PM | 12-ORA-5-12.4/14.5 |
Award Date | 12/20/2019 |
Closeout Date | Not set |
Work Description | South County Improvement Project (Phase 1 - Avery/Crown Valley) PLACE HMA, INSTALL CONC PAVEMENT, RETAIN WALL, MODIFY ELECT SYS. | Add one lane btwn 73 & Oso PKWY |
Location Description | ORANGE COUNTY IN SAN JUAN CAPISTRANO, LAGUNA HILLS, LAGUNA NIGUEL AND MISSION VIEJO FROM 0.5 MILE SOUTH OF AVERY PARKWAY UNDERCROSSING TO 0.8 MILE NORTH OF CROWN VALLEY PARKWAY OVERCROSSING |
QA Service Level | 1 (Verified on 10/31/2019) |
Sample Information
Sample Taken Date | 08/26/2022 | Sample Unique Key | 83 |
---|---|---|---|
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 testing | 08/26/2022 |
Sample type | Quality Assurance | A brief description of the sample | LCB |
The quantity of what the sample constitutes | 1 Bucket of 1", 1 Bucket of Sand | From where was the sample collected | Fabricator |
First name of sampler or witnessed by | Sam | Last name of sampler or witnessed by | Jam |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | 22-0786 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | Cemex Irvine | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Concrete | The concrete mix design number | 1610825 |
---|---|---|---|
The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 13100101 | |
Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
A detailed description of where the material sample was collected | conveyor belt | Where the material sample would have been placed if not sampled | |
From Lot No. | Bag Lot No. |
Submitted Tests
DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
---|---|---|---|---|---|---|---|---|
No results found. |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
---|---|---|---|
No results found. |