Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2025-11-18-33

Project Information

Project IdentifiersProject ID: 993223
DEA: 11TEST04
EFIS: 11TEST3101
DIST-CO-RTE-PM11---
Award Date10/01/2021
Closeout DateNot set
Work DescriptionTHIS PROJECT WAS ADDED FOR E3101 DEVELOPMENT AND TESTING PURPOSES. DATA SUBMITTED FOR THIS PROJECT MUST NOT BE USED FOR ANY OTHER PURPOSES.
Location DescriptionTHIS PROJECT WAS ADDED FOR E3101 DEVELOPMENT AND TESTING PURPOSES. DATA SUBMITTED FOR THIS PROJECT MUST NOT BE USED FOR ANY OTHER PURPOSES.
QA Service Level1 (Verified on 10/22/2021)

Sample Information

Sample Taken Date11/18/2025 Sample Unique Key33
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 testing11/18/2025
Sample typeQuality Control A brief description of the sample4x8 concrete cylinders
The quantity of what the sample constitutes1 girder From where was the sample collectedFabricator
First name of sampler or witnessed byMaziar Last name of sampler or witnessed byKazemian
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameXBD 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 numbersdfg
The truck number from where the sample was collected The batch plant ticket number from where the sample was collectedrthr
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedwheelbarrow 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