Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2025-06-17-3

Project Information

Project IdentifiersProject ID: 99999
DEA: 0322222
DIST-CO-RTE-PM03-SAC,OMG-888,99,80-0.6-0.6
Award DateNot set
Closeout DateNot set
Work DescriptionTHIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location DescriptionTHIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
QA Service Level (Verified on 04/05/2013)

Sample Information

Sample Taken Date06/17/2025 Sample Unique Key3
Date that the sample was received by the laboratory/organization performing the testingNot set Sample typeQuality Control
A brief description of the samplecore samples The quantity of what the sample constitutes4
From where was the sample collectedFabricator First name of sampler or witnessed byAdriana
Last name of sampler or witnessed byOrtiz Fiallo Title of sampler
Telephone number of sampler3238053068 Laboratory sample identification
Linked DIME Sample ID The fabricator/manufacturer/facility nameSureCast
Transportation Laboratory (TL) Number Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier Structure name
Bid ItemNot set

Material Information

Material TypePrecast Concrete The concrete mix design numberxxxxxxxxx
The truck number from where the sample was collected The batch plant ticket number from where the sample was collectedxxxxxxxx
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedwheel barow 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 TestedDate AddedVerified?Release DateTest CommentsPrivacy LevelActions
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