Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2025-12-12-21

Project Information

Project IdentifiersProject ID: 1000903
DEA: 081M0404
EFIS: 0821000091
DIST-CO-RTE-PM08-SBD-40-R140.0/R142.2
Award Date06/06/2025
Closeout DateNot set
Work DescriptionCOLD PLANE AC & RHMA, VEGETATION CONTROL (MINOR CONC), MGS, AND HTCB.
Location DescriptionSAN BERNARDINO COUNTY IN NEEDLES FROM FOX WASH OVERFLOW TO L STREET UNDERCROSSING
QA Service Level1 (Verified on 01/13/2025)

Sample Information

Sample Taken Date12/12/2025 Sample Unique Key21
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 testing12/16/2025
Sample typeQuality Assurance A brief description of the sample4x8
The quantity of what the sample constitutes6 From where was the sample collectedJob Site
First name of sampler or witnessed bychijoke Last name of sampler or witnessed byo
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameSULLY Transportation Laboratory (TL) Number
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 numberSC590B33
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected1
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedVARIOUS 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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Test File Attachments