Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2019-03-22-1
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 210569 DEA: 083555V4 EFIS: 0814000086 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-15-42.5/46.0 |
| Award Date | 11/05/2015 |
| Closeout Date | 01/18/2022 |
| Work Description | WIDEN I-15, RECONSTRUCT 3 IC'S, CONSTRUCT 2 NEW BR AND WIDEN 3 BR. |
| Location Description | SAN BERNARDINO COUNTY IN VICTORVILLE FROM 0.5 MILE NORTH OF MOJAVE DRIVE TO 1.5 MILE NORTH OF STODDARD WELLS ROAD OVERCROSSING |
| QA Service Level | 1 (Verified on 10/15/2015) |
Sample Information
| Sample Taken Date | 03/22/2019 | Sample Unique Key | 1 |
|---|---|---|---|
| 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 | 03/19/2019 |
| Sample type | Aggregate Prequalification Program | A brief description of the sample | 1" Max |
| The quantity of what the sample constitutes | 500 | From where was the sample collected | Source |
| First name of sampler or witnessed by | cfc | Last name of sampler or witnessed by | xyz |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | abc | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | Not set | |
| Structure name | Not set |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-19-0021::BIG ROCK CREEK- VULCAN |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| The plant number | Unknown | A detailed description of where the material sample was collected | Plant |
| Where the material sample would have been placed if not sampled | Unknown | Primary Aggregate Nominal Size | 1 inch |
| The concrete mix design number | Unknown | Lot number | Unknown |
| Sublot number | Unknown | Aggregate Mix Number | Not set |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||