Sample Record
Owner Lab
- CT D12 - Huntington Beach Field Laboratory
DIME Sample ID 2022-11-02-14
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Project Information
| Project Identifiers | Project ID: 993510 DEA: 120P9204 EFIS: 1216000044 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-5-38.5/41.6 |
| Award Date | 04/21/2022 |
| Closeout Date | Not set |
| Work Description | PLANTING, IRRIGATION, ROCK BLANKET, MINOR CONCRETE AND AC PAVING. |
| Location Description | ORANGE COUNTY IN ANAHEIM FROM SANTA ANA STREET OVERCROSSING TO 0.5 MILE NORTH OF LA PALMA AVENUE OVERCROSSING |
| QA Service Level | 1 (Verified on 01/24/2022) |
Sample Information
| Sample Taken Date | 11/02/2022 | Sample Unique Key | 14 |
|---|---|---|---|
| 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 | 11/03/2022 |
| Sample type | Quality Assurance | A brief description of the sample | 3/8" rock & Sand |
| The quantity of what the sample constitutes | 10 cubic yards | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | JIMMY CUONG | Last name of sampler or witnessed by | PHAM |
| Title of sampler | Lab Technician | Telephone number of sampler | 9492798487 |
| Laboratory sample identification | 22-1122 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Robertsons-Anaheim | 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 | RRM16044 |
|---|---|---|---|
| The truck number from where the sample was collected | 1997 | The batch plant ticket number from where the sample was collected | 101C705872 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Stockpile | 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. | ||||||||