Sample Record
Owner Lab
- CT D12 - Huntington Beach Field Laboratory
DIME Sample ID 2022-08-26-83
Sample Details QR Code
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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. | |||