Sample Record
Owner Lab
- CT D12 - Huntington Beach Field Laboratory
DIME Sample ID 2024-05-15-78
Sample is locked from editing. info
Project Information
Project Identifiers | Project ID: 993136 DEA: 120Q3904 EFIS: 1217000003 |
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DIST-CO-RTE-PM | 12-ORA-55-4.7 |
Award Date | 08/14/2023 |
Closeout Date | 12/02/2024 |
Work Description | RECONSTRUCT REINFORCED STRUCTURAL CONCRETE BRIDGE AND BARRIER. |
Location Description | ORANGE COUNTY IN COSTA MESA AT ROUTE 55/73 CONNECTOR |
QA Service Level | 1 (Verified on 07/27/2021) |
Sample Information
Sample Taken Date | 05/15/2024 | Sample Unique Key | 78 |
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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 | 05/16/2024 |
Sample type | Quality Assurance | A brief description of the sample | 4x8 concrete cylinders |
The quantity of what the sample constitutes | 6 | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Reza | Last name of sampler or witnessed by | Fard |
Title of sampler | Telephone number of sampler | 7144041000 | |
Laboratory sample identification | 24-0230 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | Robertson's | 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 | SC590B33 |
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The truck number from where the sample was collected | 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 | Concrete from wheelbarrow | Where the material sample would have been placed if not sampled | Bridge Deck Barrier Pour Abt 16 to hinge 13 |
From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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