Sample Record

Owner Lab

  • CT D12 - Huntington Beach Field Laboratory

DIME Sample ID 2023-08-01-27

Project Information

Project IdentifiersProject ID: 214951
DEA: 120K0234
EFIS: 1214000100
DIST-CO-RTE-PM12-ORA-5-17.1/18.9
Award Date09/23/2020
Closeout DateNot set
Work DescriptionSouth County Improvement Project (Phase 3 - El Toro/Alicia) WIDEN FREEWAY AND BRIDGES, RECONSTRUCT BRIDGE AND WALLS.
Location DescriptionORANGE COUNTY IN MISSION VIEJO, LAGUNA HILLS, LAGUNA WOODS AND LAKE FOREST FROM 0.4 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING TO 0.2 MILE NORTH OF EL TORO ROAD UNDERCROSSING
QA Service Level1 (Verified on 10/01/2020)

Sample Information

Sample Taken Date08/01/2023 Sample Unique Key27
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 testing08/01/2023
Sample typeQuality Assurance A brief description of the sampleconcrete from the bridge deck
The quantity of what the sample constitutes110 CY From where was the sample collectedManufacturer
First name of sampler or witnessed byJohnny Cuong Last name of sampler or witnessed byDo
Title of sampler Telephone number of sampler7143066148
Laboratory sample identification230740 Linked DIME Sample ID
The fabricator/manufacturer/facility nameHolliday Rock Irvine 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 number3F36L005
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected3614908
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedAt the plant 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
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Sample File Attachments

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Test File Attachments