Sample Record

Owner Lab

  • CT D12 - Huntington Beach Field Laboratory

DIME Sample ID 2023-02-02-4

Project Information

Project IdentifiersProject ID: 214344
DEA: 120P42U4
EFIS: 1216000097
DIST-CO-RTE-PM12-ORA-5,22,55,57,91,405-Var
Award Date09/15/2020
Closeout DateNot set
Work DescriptionUpgrade and install Intelligent Transportation System (ITS) elements
Location DescriptionORANGE COUNTY
QA Service Level1 (Verified on 10/27/2020)

Sample Information

Sample Taken Date02/02/2023 Sample Unique Key4
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 testing02/02/2023
Sample typeQuality Assurance A brief description of the sample1", 3/8" & SAND
The quantity of what the sample constitutes10 cubic yards From where was the sample collectedManufacturer
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 identification23-0067 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCEMEX - ORANGE 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 number1610825
The truck number from where the sample was collected10067814 The batch plant ticket number from where the sample was collected30613484
Concrete batch plant The fabricator/manufacturer designation for the sampleBatch plant
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
23-0067-TICKET-1610825jpg02/02/2023   Info
23-0067-PCC-1610825pdf02/02/2023   Info

Test File Attachments