Sample Record
Owner Lab
- CT D12 - Huntington Beach Field Laboratory
DIME Sample ID 2024-06-13-94
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Project Information
| Project Identifiers | Project ID: 214698 DEA: 120N8904 EFIS: 1214000130 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-133-8.3/M9.3 |
| Award Date | 11/09/2023 |
| Closeout Date | Not set |
| Work Description | CONSTRUCT AUXILIARY LANE. |
| Location Description | ORANGE COUNTY IN IRVINE FROM ROUTE 133/405 SEPARATION TO IRVINE CENTER DRIVE OVERCROSSING |
| QA Service Level | 1 (Verified on 02/22/2021) |
Sample Information
| Sample Taken Date | 06/13/2024 | Sample Unique Key | 94 |
|---|---|---|---|
| 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 | 06/14/2024 |
| 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 | Younho | Last name of sampler or witnessed by | Rew |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 24-0269 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Security Paving | 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 | S72C447T14 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 418443 | |
| 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 | 405/133 |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
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|---|---|---|---|
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