Sample Record
Owner Lab
- CT D12 - Huntington Beach Field Laboratory
DIME Sample ID 2023-07-24-13
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994254 DEA: 120R2904 EFIS: 1218000076 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-22-R5.5 |
| Award Date | 11/09/2022 |
| Closeout Date | Not set |
| Work Description | PLACE HIGH FRICTION SURFACE TREATMENT, LOOP DETECTORS, MGS AND CB. |
| Location Description | ORANGE COUNTY IN GARDEN GROVE AT WESTBOUND BROOKHURST STREET ON-RAMP AND OFF-RAMP |
| QA Service Level | 1 (Verified on 01/10/2023) |
Sample Information
| Sample Taken Date | 07/24/2023 | Sample Unique Key | 13 |
|---|---|---|---|
| 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 | 07/25/2023 |
| Sample type | Quality Assurance | A brief description of the sample | 1", 3/8" & SANDS |
| The quantity of what the sample constitutes | 20 CU.YDS | 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 | 23-0712 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Associated Fountain Valley | 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 | 556300 |
|---|---|---|---|
| The truck number from where the sample was collected | 0679 | The batch plant ticket number from where the sample was collected | 45086768 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | conveyor belt | 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. | ||||||||