Sample Record
Owner Lab
- CT D12 - Huntington Beach Field Laboratory
DIME Sample ID 2022-11-10-31
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Project Information
| Project Identifiers | Project ID: 993136 DEA: 120Q3904 EFIS: 1217000003 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-55-4.7 |
| Award Date | 09/20/2021 |
| Closeout Date | Not set |
| Work Description | RECONSTRUCT REINFORCED STRUCTURAL CONCRETE BRIDGE AND BARRIER. |
| Location Description | ORANGE COUNTY IN COSTA MESA AT ROUTE 55/73 CONNECTOR |
| QA Service Level | 1 (Verified on 07/27/2021) |
Sample Information
| Sample Taken Date | 11/10/2022 | Sample Unique Key | 31 |
|---|---|---|---|
| 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 | 11/10/2022 |
| Sample type | Quality Assurance | A brief description of the sample | Course and fine aggregate |
| The quantity of what the sample constitutes | 1 Bucket of 1", 1 Bucket of 3/8", One Bucket of Sand | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Sam | Last name of sampler or witnessed by | Jamyari |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 22-1152 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Robertson’s Ready mix Irvine | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-33-0061 |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | The fabricator/manufacturer designation for the sample | ||
| The plant number | A detailed description of where the material sample was collected | Conveyor Belt | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 1 inch | |
| The concrete mix design number | SC590M35 | Lot number | |
| Sublot number | Aggregate Mix Number |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-11-10-31-1 CTM 202-November 2011 (Verified)