Sample Record

Owner Lab

  • Alta Vista Solutions - Whittier

DIME Sample ID 2024-05-30-103

Project Information

Project IdentifiersProject ID: 995085
DEA: 07322904
EFIS: 0716000059
DIST-CO-RTE-PM07-LA-27-0.0/18.6
Award Date11/06/2023
Closeout DateNot set
Work DescriptionREMOVE EXISTING AC PAVEMENT & HMA OVERLAY.
Location DescriptionLOS ANGELES COUNTY IN AND NEAR LOS ANGELES FROM ROUTE 1 TO DEVONSHIRE STREET
QA Service Level1 (Verified on 09/11/2023)

Sample Information

Sample Taken Date05/30/2024 Sample Unique Key103
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 testing05/31/2024
Sample typeQuality Assurance A brief description of the sampleLCB-RS
The quantity of what the sample constitutes 10 CY From where was the sample collectedJob Site
First name of sampler or witnessed byDominic Last name of sampler or witnessed byMontemayor
Title of sampler Telephone number of sampler
Laboratory sample identification24-1226 Linked DIME Sample ID
The fabricator/manufacturer/facility nameN/A Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberCTS-30-EHI (LCB-RS)
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected1
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedConcrete from wheelbarrow Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2024-05-30-103-1CTM 557-June 2020: Method of Test for Temperature of Freshly Mixed Hydraulic Cement ConcreteDominic Montemayor, Alta Vista Solutions - Whittier05/30/2024SoCal Reports
Yes
07/12/2024

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2024-05-30-103-1 CTM 557-June 2020 (Verified)