Sample Record
Owner Lab
- CT D12 - Huntington Beach Field Laboratory
DIME Sample ID 2022-11-10-21
Sample is locked from editing. info
Project Information
Project Identifiers | Project ID: 208973 DEA: 120H1004 EFIS: 1200000180 COOP: 120670 |
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DIST-CO-RTE-PM | 12-ORA-405,73,405,605-9.3/24.3 |
Award Date | 11/07/2016 |
Closeout Date | Not set |
Work Description | (Alternative Delivery) San Diego Freeway (I-405) Improvement Project SR-73 to I-605, Design Build Project, Administered by Orange County Transportation Authority, Caltrans METS to perform Source Inspection per RFP. |
Location Description | Orange and Los Angeles Counties: 12-ORA-405 PM 9.3/24.2 / 07-LA-405 PM 0.0/1.2 12-ORA-22 PM R0.7/R3.8 / 12-ORA-22 PM R0.5/R0.7 12-ORA-73 PM R27.2/R27.8 / 12-ORA-605 PM 3.5/R1.6 07-LA-605 PM R0.0/R1.2 |
QA Service Level | 1 (Verified on 09/10/2015) |
Sample Information
Sample Taken Date | 11/10/2022 | Sample Unique Key | 21 |
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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 | 11/11/2022 |
Sample type | Quality Assurance | A brief description of the sample | 1" rock, 3/8" rock and sand |
The quantity of what the sample constitutes | 100 Cubic Yards | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Bond | Last name of sampler or witnessed by | Mekchai |
Title of sampler | Lab Technician | Telephone number of sampler | 6265327705 |
Laboratory sample identification | 22-0419 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | OC405 PARTNERS-BEACH BLVD | 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 | G3-18-BAR-131 |
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The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 6 | |
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
Test File Attachments
DIME Test ID: 2022-11-10-21-1 CTM 521-June 2020 (Verified)
File Name | Extension | Date Uploaded | Test ID | Actions |
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22-0419 | 12/11/2022 | 2022-11-10-21-1 | Info |