Sample Record

Owner Lab

  • CT D07 - Plant Services

DIME Sample ID 2024-01-19-2

Project Information

Project IdentifiersProject ID: 215220
DEA: 07210624
EFIS: 0719000068
DIST-CO-RTE-PM07-LA,SBD-71-1.8/R4.7&R0.0/R0.2
Award Date02/05/2021
Closeout DateNot set
Work DescriptionPLACE STRUCTURE CONCRETE RETAINING WALLS & BOX CULVERT AND PLACE JPCP.
Location DescriptionIN LOS ANGELES AND SAN BERNARDINO COUNTIES IN POMONA AND CHINO HILLS FROM 0.2 MILE SOUTH OF MISSION BOULEVARD OVERCROSSING TO 0.2 MILE OF SAN BERNARDINO COUNTY LINE.
QA Service Level1 (Verified on 03/24/2021)

Sample Information

Sample Taken Date01/19/2024 Sample Unique Key2
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 testing01/19/2024
Sample typeDepartment Acceptance A brief description of the sample3/8 x No. 8 PCC Aggregate
The quantity of what the sample constitutes50 CY From where was the sample collectedManufacturer
First name of sampler or witnessed byHonesto Last name of sampler or witnessed byCastillo
Title of samplerMREAS Telephone number of sampler12134537563
Laboratory sample identification006B Linked DIME Sample ID2024-01-19-1 & 2024-01-19-3
The fabricator/manufacturer/facility nameRobertson Ready Mix Concrete-Pomona Transportation Laboratory (TL) NumberC-006762
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-33-0061
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number5 A detailed description of where the material sample was collectedBelt Cut at Plant
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/8 inch
The concrete mix design numberSC590B38 Lot number
Sublot number Aggregate Mix Number

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2024-01-19-2-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesHonesto Castillo, CT D07 - Plant Services01/19/2024Honesto Castillo
Yes
02/05/2024

Sample File Attachments

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Test File Attachments


DIME Test ID: 2024-01-19-2-1 CTM 202-November 2011 (Verified)