Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2019-09-10-23
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Project Information
| Project Identifiers | Project ID: 210837 DEA: 080J0804 EFIS: 0800000283 COOP: 081625 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-15-34.7/51.6 |
| Award Date | 04/17/2017 |
| Closeout Date | Not set |
| Work Description | (Alternative Delivery) DESIGN-BUILD OF THE INTERSTATE 15 EXPRESS LANES PROJECT |
| Location Description | Riverside County and SBD-15-0.0/1.3 |
| QA Service Level | 1 (Verified on 05/08/2017) |
Sample Information
| Sample Taken Date | 09/10/2019 | Sample Unique Key | 23 |
|---|---|---|---|
| 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 | 09/12/2019 |
| Sample type | Quality Assurance | A brief description of the sample | 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 4 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Seyed | Last name of sampler or witnessed by | Mirgati |
| Title of sampler | TET | Telephone number of sampler | |
| Laboratory sample identification | 974-96 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | ROBERTSON CORONA | Transportation Laboratory (TL) Number | 96 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | East Corona Rt Bridge Widen deck pour | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | RRM17052 |
|---|---|---|---|
| The truck number from where the sample was collected | 1722 | The batch plant ticket number from where the sample was collected | 4951802 |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | SKANSKA AMES |
| A detailed description of where the material sample was collected | 125 cy | Where the material sample would have been placed if not sampled | East Corona Rt Bridge Widen deck pour |
| 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: 2019-09-10-23-1 ASTM C39-10 (Verified)