Sample Record
Owner Lab
- CT D08 - Fontana Field Testing Laboratory
DIME Sample ID 2021-08-24-15
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Project Information
| Project Identifiers | Project ID: 215612 DEA: 081L6904 EFIS: 0820000139 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-10,60-9.9/R24.2,R0.0/R4.6 |
| Award Date | 05/06/2021 |
| Closeout Date | 10/13/2022 |
| Work Description | INDIVIDUAL SLAB REPLACEMENT. |
| Location Description | SAN BERNARDINO COUNTY ON ROUTE 10 FROM ROUTE 15 TO ROUTE 215 AND ON ROUTE 60 FROM 0.1 MILE EAST OF RESERVOIR STREET UNDERCROSSING TO EUCLID AVENUE UNDERCROSSING |
| QA Service Level | 1 (Verified on 06/23/2021) |
Sample Information
| Sample Taken Date | 08/24/2021 | Sample Unique Key | 15 |
|---|---|---|---|
| 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 | 08/25/2021 |
| Sample type | Quality Assurance | A brief description of the sample | PCC Rapid set beams |
| The quantity of what the sample constitutes | 3 beams | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | QC | Last name of sampler or witnessed by | QC |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 3RA,3RB,3RC | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Myers and Sons Construction | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | 800-3RSC |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | TTI | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | On Job Site at Concrete Truck | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-08-24-15-1 CTM 524-March 2013 (Verified)
DIME Test ID: 2021-08-24-15-2 CTM 524-March 2013 (Verified)
DIME Test ID: 2021-08-24-15-3 CTM 524-March 2013 (Verified)