Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2017-09-07-3
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Project Information
| Project Identifiers | Project ID: 211070 DEA: 080Q3004 EFIS: 0800020191 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-138-R17.1/R19.2 |
| Award Date | 04/18/2016 |
| Closeout Date | 09/28/2020 |
| Work Description | REALIGN SECTION OF STATE ROUTE 138 |
| Location Description | Near Hesperia from 1.9 mi East of Route 15 to 0.1 mi West of Summit Post Office Road to realign sections of State Route 138 |
| QA Service Level | 1 (Verified on 04/27/2016) |
Sample Information
| Sample Taken Date | 09/07/2017 | Sample Unique Key | 3 |
|---|---|---|---|
| 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 testing | 09/11/2017 |
| Sample type | Quality Assurance | A brief description of the sample | 6x12 concrete cylindes |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | V | Last name of sampler or witnessed by | WAMI |
| Title of sampler | ASR | Telephone number of sampler | Unknown |
| Laboratory sample identification | 955-907A | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | Roberts Lucern Valley | Transportation Laboratory (TL) Number | 20170907 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | Double Drain Creek Bridge stem and soffit 2 |
| Structure name | Double Drain Creek Bridge stem and soffit 2 | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | RRM09013 |
|---|---|---|---|
| The truck number from where the sample was collected | 1180 | The batch plant ticket number from where the sample was collected | 2871838 |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| A detailed description of where the material sample was collected | Chute | Where the material sample would have been placed if not sampled | Double Drain Creek Bridge stem and soffit 2 |
| From Lot No. | Unknown | Bag Lot No. | Unknown |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2017-09-07-3-1 ASTM C39-17a (Verified)