Sample Record

Owner Lab

  • Con-Fab California Corporation - Shafter

DIME Sample ID 2020-07-07-1

Project Information

Project IdentifiersProject ID: 212112
DEA: 080C2514
EFIS: 0816000076
COOP: 081645
DIST-CO-RTE-PM08-SBD-10-0.0/13.2
Award Date06/06/2018
Closeout DateNot set
Work DescriptionDesign-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes
Location DescriptionLA/SBD County Line to PM 13.2 near I-15
QA Service Level1 (Verified on 10/16/2019)

Sample Information

Sample Taken Date07/07/2020 Sample Unique Key1
Date that the sample was received by the laboratory/organization performing the testing07/08/2020 Sample typeQuality Control
A brief description of the sample6x12 concrete cylinders The quantity of what the sample constitutes12
From where was the sample collectedFabricator First name of sampler or witnessed byTrevor
Last name of sampler or witnessed byLaws Title of samplerQC Manager
Telephone number of sampler Laboratory sample identificationSultana 7-7-20
Linked DIME Sample ID The fabricator/manufacturer/facility nameConfab Shafter
Transportation Laboratory (TL) Number Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier Structure nameSultana Bridge OC
Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design numberSCC-S9_8-10F
The truck number from where the sample was collected3 The batch plant ticket number from where the sample was collected1976
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedBack of Truck Where the material sample would have been placed if not sampledUnknown
From Lot No.Unknown Bag Lot No.Unknown

Submitted Tests

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