Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2025-06-18-2

Project Information

Project IdentifiersProject ID: 215042
DEA: 100TST04
EFIS: 1020999999
DIST-CO-RTE-PM10-STA-5-26.1/27.0
Award DateNot set
Closeout DateNot set
Work DescriptionThis is just a test EA, not tied to an actual project at all. Don't believe anything you read.
Location DescriptionNot set
QA Service Level1 (Verified on 06/29/2020)

Sample Information

Sample Taken Date06/18/2025 Sample Unique Key2
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testingNot set
Sample typeQuality Control A brief description of the samplecores
The quantity of what the sample constitutes3 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 nameCoreslab Structures 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 number9999999
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected9999999
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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Sample File Attachments

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Test File Attachments