Sample Record

Owner Lab

  • CT D12 - Huntington Beach Field Laboratory

DIME Sample ID 2022-11-15-17

Project Information

Project IdentifiersProject ID: 208973
DEA: 120H1004
EFIS: 1200000180
COOP: 120670
DIST-CO-RTE-PM12-ORA-405,73,405,605-9.3/24.3
Award Date11/07/2016
Closeout DateNot 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 DescriptionOrange 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 Level1 (Verified on 09/10/2015)

Sample Information

Sample Taken Date11/15/2022 Sample Unique Key17
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 testing11/15/2022
Sample typeQuality Assurance A brief description of the sample1" rock, 3/8" rock & sand
The quantity of what the sample constitutes100 Cubic Yards From where was the sample collectedJob Site
First name of sampler or witnessed byJIMMY CUONG Last name of sampler or witnessed byPHAM
Title of samplerLab Technician Telephone number of sampler9492798487
Laboratory sample identification22-1157 Linked DIME Sample ID
The fabricator/manufacturer/facility nameOC405 PARTNERS-BEACH BLVD Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberG3-18-BAR-131
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected17
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedStockpile Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.

Sample File Attachments

File NameExtensionDate UploadedActions
22-1157jpg11/16/2022   Info
22-1157pdf11/16/2022   Info

Test File Attachments