Sample Record
Owner Lab
- CT D12 - Huntington Beach Field Laboratory
DIME Sample ID 2023-11-16-29
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994255 DEA: 120R5004 EFIS: 1218000101 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-55-0.6 |
| Award Date | 10/31/2022 |
| Closeout Date | Not set |
| Work Description | MODIFY SIGNAL AND LIGHTING SYSTEMS AND CONSTRUCT SIDEWALK CURB RAMPS. |
| Location Description | ORANGE COUNTY IN NEWPORT BEACH AT HOSPITAL ROAD |
| QA Service Level | 1 (Verified on 02/03/2023) |
Sample Information
| Sample Taken Date | 11/16/2023 | Sample Unique Key | 29 |
|---|---|---|---|
| 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 | 11/16/2023 |
| Sample type | Quality Assurance | A brief description of the sample | concrete |
| The quantity of what the sample constitutes | 10 CY | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Johnny Cuong | Last name of sampler or witnessed by | Do |
| Title of sampler | Telephone number of sampler | 7143066148 | |
| Laboratory sample identification | 23-1277 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Cemex Irvine | 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 | 1610838 |
|---|---|---|---|
| The truck number from where the sample was collected | 1 | The batch plant ticket number from where the sample was collected | 1 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | At Cemex Irvine | 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. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| 23-1227 | 11/17/2023 | Info |