Sample Record
Owner Lab
- CT D12 - Huntington Beach Field Laboratory
DIME Sample ID 2023-02-03-19
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214344 DEA: 120P42U4 EFIS: 1216000097 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-5,22,55,57,91,405-Var |
| Award Date | 09/15/2020 |
| Closeout Date | Not set |
| Work Description | Upgrade and install Intelligent Transportation System (ITS) elements |
| Location Description | ORANGE COUNTY |
| QA Service Level | 1 (Verified on 10/27/2020) |
Sample Information
| Sample Taken Date | 02/03/2023 | Sample Unique Key | 19 |
|---|---|---|---|
| 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 | 02/03/2023 |
| Sample type | Quality Assurance | A brief description of the sample | 1", 3/8" & SAND |
| The quantity of what the sample constitutes | 10 cubic yards | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | JIMMY CUONG | Last name of sampler or witnessed by | PHAM |
| Title of sampler | Lab Technician | Telephone number of sampler | 9492798487 |
| Laboratory sample identification | 23-0073 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | CEMEX - ORANGE | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | 1610825 |
|---|---|---|---|
| The truck number from where the sample was collected | 10067813 | The batch plant ticket number from where the sample was collected | 30615277 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Stockpile | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||