Sample Record

Owner Lab

  • CT D12 - Huntington Beach Field Laboratory

DIME Sample ID 2022-11-20-1

Project Information

Project IdentifiersProject ID: 214355
DEA: 120K0214
EFIS: 1214000096
DIST-CO-RTE-PM12-ORA-5-12.4/14.5
Award Date12/20/2019
Closeout DateNot set
Work DescriptionSouth 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 DescriptionORANGE 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 Level1 (Verified on 10/31/2019)

Sample Information

Sample Taken Date11/20/2022 Sample Unique Key1
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing11/20/2022
Sample typeAcceptance A brief description of the sample3/4" RHMAG SP
The quantity of what the sample constitutes17 boxes of RHMA-G, 4 Bags Virgin Agg, Oil 2 Cans, LAS 1 Can From where was the sample collectedManufacturer
First name of sampler or witnessed bySam Last name of sampler or witnessed byJamyari
Title of sampler Telephone number of sampler19492794998
Laboratory sample identification22-1170 Linked DIME Sample ID
The fabricator/manufacturer/facility nameAAA Irvine Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeHot Mix Asphalt HMA TypeRHMA-G
HMA Grading3/4 inch Lot number
Sublot number HMA Mix Number106835

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.

Sample File Attachments

File NameExtensionDate UploadedActions
Scanned Documentspdf11/21/2022   Info

Test File Attachments