Sample Record

Owner Lab

  • CT D12 - Huntington Beach Field Laboratory

DIME Sample ID 2023-03-30-70

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 Date03/30/2023 Sample Unique Key70
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 testing03/30/2023
Sample typeQuality Assurance A brief description of the sample6x6x18 Beam
The quantity of what the sample constitutes2 From where was the sample collectedJob Site
First name of sampler or witnessed byJohnny Last name of sampler or witnessed byDo
Title of sampler Telephone number of sampler7143066148
Laboratory sample identification23-0106 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 collected The batch plant ticket number from where the sample was collected1
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedConcrete from wheelbarrow Where the material sample would have been placed if not sampledNB 405 Under Bear St Bridge Center Median PCC
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2023-03-30-70-1CTM 523-May 2020: Method of Test for Flexural Strength of ConcreteDan Morris, CT D12 - Huntington Beach Field Laboratory04/27/2023Sam Jamyari
Yes
05/15/2023

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2023-03-30-70-1 CTM 523-May 2020 (Verified)
File NameExtensionDate UploadedTest IDActions
23-0106pdf04/28/20232023-03-30-70-1   Info