Sample Record

DIME Sample ID 2025-08-22-42

Project Information

Project IdentifiersProject ID: 215220
DEA: 07210624
EFIS: 0719000068
DIST-CO-RTE-PM07-LA,SBD-71-1.8/R4.7&R0.0/R0.2
Award Date02/05/2021
Closeout DateNot set
Work DescriptionPLACE STRUCTURE CONCRETE RETAINING WALLS & BOX CULVERT AND PLACE JPCP.
Location DescriptionIN LOS ANGELES AND SAN BERNARDINO COUNTIES IN POMONA AND CHINO HILLS FROM 0.2 MILE SOUTH OF MISSION BOULEVARD OVERCROSSING TO 0.2 MILE OF SAN BERNARDINO COUNTY LINE.
QA Service Level1 (Verified on 03/24/2021)

Owner Lab

  • CT D07 - Materials Field Laboratory, Unit 1953

Sample Information

Sample Taken Date08/22/2025 Sample Unique Key42
Date that the sample was received by the laboratory/organization performing the testing09/05/2025 Sample typeAcceptance
A brief description of the sample4X8 PCC cylinders The quantity of what the sample constitutes130 CY
From where was the sample collectedJob Site First name of sampler or witnessed byNoura
Last name of sampler or witnessed byAlayyan Title of samplerAssistant Structure Representative
Telephone number of sampler Laboratory sample identification25-912
Linked DIME Sample ID The fabricator/manufacturer/facility nameRobertsons Pomona
Transportation Laboratory (TL) Number07-210624-54 Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier Structure name
Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design numberSSC675B38
The truck number from where the sample was collected2 The batch plant ticket number from where the sample was collected1871729
Concrete batch plantRobertsons Pomona The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedtruck chute 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


DIME Test ID: 2025-08-22-42-1 CTM 521-June 2020 (Verified)
DIME Test ID: 2025-08-22-42-2 CTM 521-June 2020 (Verified)