Sample Record

DIME Sample ID 2017-08-30-4

Project Information

Project IdentifiersProject ID: 211714
DEA: 080R1204
EFIS: 0812000026
DIST-CO-RTE-PM08-SBD-40-0.0/R25.0
Award Date12/21/2016
Closeout Date06/23/2021
Work DescriptionREGRADE MEDIAN CROSS SLOPE
Location DescriptionSAN BERNARDINO COUNTY IN AND NEAR BARSTOW FROM JUNCTION 15/40 TO 1.4 MILES EAST OF FORT CADY ROAD OVERCROSSING
QA Service Level1 (Verified on 09/21/2016)

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

Sample Information

Sample Taken Date08/30/2017 Sample Unique Key4
Date that the sample was received by the laboratory/organization performing the testing09/06/2017 Sample typeQuality Assurance
A brief description of the sample6X12 The quantity of what the sample constitutes2
From where was the sample collectedJob Site First name of sampler or witnessed byKENNEDY
Last name of sampler or witnessed byE Title of samplerNOT PROVIDED
Telephone number of samplerUnknown Laboratory sample identification957-017
Linked DIME Sample IDUnknown The fabricator/manufacturer/facility nameROBERTSON BARSTOW
Transportation Laboratory (TL) Number083017 Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown
Structure unique identifierDS Structure nameUnknown
Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design number5264125A
The truck number from where the sample was collectedNOT PROVIDED The batch plant ticket number from where the sample was collectedNOT PROVIDED
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedLOAD 1 Where the material sample would have been placed if not sampledDS 206 STA 1081 77
From Lot No.Unknown Bag Lot No.Unknown

Submitted Tests

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