Sample Record
Owner Lab
- CT D12 - Huntington Beach Field Laboratory
DIME Sample ID 2022-12-27-3
Project Information
Project Identifiers | Project ID: 214355 DEA: 120K0214 EFIS: 1214000096 |
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DIST-CO-RTE-PM | 12-ORA-5-12.4/14.5 |
Award Date | 12/20/2019 |
Closeout Date | Not set |
Work Description | South 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 Description | ORANGE 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 Level | 1 (Verified on 10/31/2019) |
Sample Information
Sample Taken Date | 12/27/2022 | Sample Unique Key | 3 |
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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 testing | 12/27/2022 |
Sample type | Quality Assurance | A brief description of the sample | 3/4" HMA type A |
The quantity of what the sample constitutes | 17 boxes of HMA, 4 bags of combined agg, 1 bag of RAP, 2 quarts of binder | 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 | 9492798470 | |
Laboratory sample identification | 22-1252 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | AAA Corona | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Hot Mix Asphalt | HMA Type | Type A HMA |
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HMA Grading | 3/4 inch | Lot number | |
Sublot number | HMA Mix Number | 105793 |
Submitted Tests
DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
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No results found. |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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Caltrans | 12/27/2022 | Info |