Sample Record

Owner Lab

  • CT D07 - Materials Field Laboratory, Unit 1953

DIME Sample ID 2026-01-23-29

Project Information

Project IdentifiersProject ID: 1000851
DEA: 07351704
EFIS: 0718000204
DIST-CO-RTE-PM07-VEN-118,118-15.6/R17.9
Award Date03/25/2025
Closeout DateNot set
Work DescriptionCOLD PLANE AC PAVEMENT AND PLACE RUBBERIZED HMA.
Location DescriptionVENTURA COUNTY IN MOORPARK AT VARIOUS LOCATIONS
QA Service Level1 (Verified on 03/11/2025)

Sample Information

Sample Taken Date01/23/2026 Sample Unique Key29
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 testing01/24/2026
Sample typeAcceptance A brief description of the sample6 x 12 LCB Cylinders
The quantity of what the sample constitutes 150 cy From where was the sample collectedJob Site
First name of sampler or witnessed byjacinto Last name of sampler or witnessed byvillanueva
Title of samplerTEC Telephone number of sampler8182096574
Laboratory sample identification26-0275 Linked DIME Sample ID
The fabricator/manufacturer/facility nameRassmunson 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 number2024-LCBRS
The truck number from where the sample was collected114 The batch plant ticket number from where the sample was collected114
Concrete batch plant The fabricator/manufacturer designation for the samplerassmusson
A detailed description of where the material sample was collectedon site nexty to the truck Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

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