Sample Record
Owner Lab
- CT D12 - Huntington Beach Field Laboratory
DIME Sample ID 2023-09-27-34
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994146 DEA: 120R1904 EFIS: 1218000064 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-91-5.4/5.8 |
| Award Date | 10/14/2022 |
| Closeout Date | 02/02/2024 |
| Work Description | FURNISH AND INSTALL SIGN STRUCTURE AND REPLACE SIGN PANELS. |
| Location Description | ORANGE COUNTY IN ANAHEIM ON WESTBOUND ROUTE 91 FROM 0.4 MILE WEST OF ROUTE 57/91 SEPARATION TO 0.1 MILE WEST OF PLACENTIA AVENUE OVERCROSSING |
| QA Service Level | 1 (Verified on 03/03/2023) |
Sample Information
| Sample Taken Date | 09/27/2023 | Sample Unique Key | 34 |
|---|---|---|---|
| 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 | 09/28/2023 |
| Sample type | Quality Assurance | A brief description of the sample | 1", 3/8" & SAND |
| The quantity of what the sample constitutes | 30 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 | 23-1004 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | ROBERTSONS - ANAHEIM | 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 | SC590B38 |
|---|---|---|---|
| The truck number from where the sample was collected | 2187 | The batch plant ticket number from where the sample was collected | 8092046 |
| 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. | ||||||||