Sample Record

DIME Sample ID 2017-12-08-5

Project Information

Project IdentifiersProject ID: 211070
DEA: 080Q3004
EFIS: 0800020191
DIST-CO-RTE-PM08-SBD-138-R17.1/R19.2
Award Date04/18/2016
Closeout Date09/28/2020
Work DescriptionREALIGN SECTION OF STATE ROUTE 138
Location DescriptionNear 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 Level1 (Verified on 04/27/2016)

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

Sample Information

Sample Taken Date12/08/2017 Sample Unique Key5
Date that the sample was received by the laboratory/organization performing the testing12/14/2017 Sample typeQuality Assurance
A brief description of the sample6x12 concrete cylindes The quantity of what the sample constitutes2
From where was the sample collectedJob Site First name of sampler or witnessed byEDDY
Last name of sampler or witnessed bySCOTT Title of samplerASR
Telephone number of samplerUnknown Laboratory sample identification955-208B
Linked DIME Sample IDUnknown The fabricator/manufacturer/facility nameRobertsons Lucerne Valley
Transportation Laboratory (TL) Number20171208B Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown
Structure unique identifierMINER SHACK APPROACH SLABS 1 AND 3 STATION 89 PLUS 109PLUS 15 Structure nameMINER SHACK APPROACH SLABS 1 AND 3 STATION 89 PLUS 109PLUS 15
Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design numberRRM09013
The truck number from where the sample was collected1707 The batch plant ticket number from where the sample was collected3118722
Concrete batch plantRobertsons Batch Plant Lucerne The fabricator/manufacturer designation for the sampleRobertsons Batch Plant Lucerne
A detailed description of where the material sample was collectedchute Where the material sample would have been placed if not sampledAPPROACH SLAB 3
From Lot No.Unknown Bag Lot No.Unknown

Submitted Tests

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