Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2021-10-26-25

Project Information

Project IdentifiersProject ID: 215188
DEA: 080F5434
EFIS: 0817000239
Permit Numbers: 0823NMC0369
DIST-CO-RTE-PM08-RIV-I-15,SR-91-6.1-7.6
Award Date03/11/2020
Closeout Date06/05/2024
Work DescriptionI-15 ELC: 15/91 Express Lanes Connector Project (ELC)
Location DescriptionJunction of I-15 and SR-91 in Corona, CA
QA Service Level1 (Verified on 09/16/2020)

Sample Information

Sample Taken Date10/26/2021 Sample Unique Key25
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 testing10/27/2021
Sample typeQuality Assurance A brief description of the sample6x12
The quantity of what the sample constitutes6 From where was the sample collectedJob Site
First name of sampler or witnessed byzachariah Last name of sampler or witnessed byroush
Title of samplerCONSULTANT TECH Telephone number of sampler
Laboratory sample identification1026-4 Linked DIME Sample ID
The fabricator/manufacturer/facility namecemex Transportation Laboratory (TL) Number4
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design number1419984
The truck number from where the sample was collected10067840 The batch plant ticket number from where the sample was collected29923956
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedjob Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments