Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2017-09-14-8

Project Information

Project IdentifiersProject ID: 211988
DEA: 081C5104
EFIS: 0812000324
DIST-CO-RTE-PM08-RIV-74-17.4/17.8
Award Date03/09/2017
Closeout Date06/23/2021
Work DescriptionCONSTRUCT VEHICLE RINSE FACILITY
Location DescriptionRIVERSIDE COUNTY IN AND NEAR LAKE ELSINORE AT THE ELSINORE MAINTENANCE STATION AND FROM DEXTER AVENUE TO CONRAD AVENUE
QA Service Level1 (Verified on 08/08/2017)

Sample Information

Sample Taken Date09/14/2017 Sample Unique Key8
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 testing09/18/2017
Sample typeQuality Assurance A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes4 From where was the sample collectedJob Site
First name of sampler or witnessed byArnel Last name of sampler or witnessed byVega
Title of samplerASR Telephone number of samplerUnknown
Laboratory sample identification967-01 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameUnknown Transportation Laboratory (TL) Number01
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierUnknown
Structure nameUnknown

Material Information

Material TypeConcrete The concrete mix design numberC8363P
The truck number from where the sample was collected074 The batch plant ticket number from where the sample was collected149993
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedFOOTINGS Where the material sample would have been placed if not sampledUnknown
From Lot No.Unknown Bag Lot No.Unknown

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments