Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2018-12-11-4
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Project Information
| Project Identifiers | Project ID: 212319 DEA: 07286604 EFIS: 0700020900 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-1,91,405-0.1-4.0 |
| Award Date | 02/22/2018 |
| Closeout Date | 04/28/2021 |
| Work Description | SHOPP PROGRAM: STORM WATER MITIGATIONS FOR LOS CERRITOS CHANNEL & ALAMITOS BAY WATERSHED IN LOS ANGELES COUNTY. |
| Location Description | ON SR-22, SR-91 & I-405 |
| QA Service Level | 1 (Verified on 04/28/2021) |
Sample Information
| Sample Taken Date | 12/11/2018 | Sample Unique Key | 4 |
|---|---|---|---|
| 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 testing | 12/13/2018 |
| Sample type | Quality Assurance | A brief description of the sample | 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Juan | Last name of sampler or witnessed by | arias |
| Title of sampler | TE Civil | Telephone number of sampler | Unknown |
| Laboratory sample identification | 990-5152 | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | National Ready Mix | Transportation Laboratory (TL) Number | 166351 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | wb 91 at lakewood off ramp |
| Structure name | wb 91 at lakewood off ramp |
Material Information
| Material Type | Concrete | The concrete mix design number | s29000LCB |
|---|---|---|---|
| The truck number from where the sample was collected | 20034 | The batch plant ticket number from where the sample was collected | 232635 |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | ortiz enterizes inc |
| A detailed description of where the material sample was collected | at 20CY | Where the material sample would have been placed if not sampled | wb 91 at lakewood off ramp |
| From Lot No. | Unknown | Bag Lot No. | Unknown |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2018-12-11-4-1 ASTM C39-10 (Verified)