Sample Record

Owner Lab

  • CT D12 - Huntington Beach Field Laboratory

DIME Sample ID 2023-02-17-15

Project Information

Project IdentifiersProject ID: 208973
DEA: 120H1004
EFIS: 1200000180
COOP: 120670
DIST-CO-RTE-PM12-ORA-405,73,405,605-9.3/24.3
Award Date11/07/2016
Closeout DateNot set
Work Description(Alternative Delivery) San Diego Freeway (I-405) Improvement Project SR-73 to I-605, Design Build Project, Administered by Orange County Transportation Authority, Caltrans METS to perform Source Inspection per RFP.
Location DescriptionOrange and Los Angeles Counties: 12-ORA-405 PM 9.3/24.2 / 07-LA-405 PM 0.0/1.2 12-ORA-22 PM R0.7/R3.8 / 12-ORA-22 PM R0.5/R0.7 12-ORA-73 PM R27.2/R27.8 / 12-ORA-605 PM 3.5/R1.6 07-LA-605 PM R0.0/R1.2
QA Service Level1 (Verified on 09/10/2015)

Sample Information

Sample Taken Date02/17/2023 Sample Unique Key15
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 testing02/17/2023
Sample typeQuality Assurance A brief description of the sample1", 3/8" & SAND
The quantity of what the sample constitutes250 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 identification23-0146 Linked DIME Sample ID
The fabricator/manufacturer/facility nameAssociated Fountain Valley 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 numberCT675CP
The truck number from where the sample was collected0589 The batch plant ticket number from where the sample was collected197746
Concrete batch plant The fabricator/manufacturer designation for the sample
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
23-0146-TICKET-CT675CPjpg02/17/2023   Info
23-0146-PCC-CT675CPpdf02/17/2023   Info

Test File Attachments