Sample Record

DIME Sample ID 2021-12-04-4

Project Information

Project IdentifiersProject ID: 215690
DEA: 074W9504
EFIS: 0720000200
DIST-CO-RTE-PM07-LA-91-R12.1/R20.7
Award Date06/02/2021
Closeout Date05/26/2022
Work DescriptionINDIVIDUAL SLAB REPLACEMENT.
Location DescriptionLOS ANGELES COUNTY IN LONG BEACH AND CERRITOS FROM ATLANTIC AVENUE UNDERCROSSING TO THE ORANGE COUNTY LINE
QA Service Level1 (Verified on 08/16/2021)

Owner Lab

  • CT D07 - Materials Field Laboratory, Unit 1953

Sample Information

Sample Taken Date12/04/2021 Sample Unique Key4
Date that the sample was received by the laboratory/organization performing the testing12/04/2021 Sample typeDepartment Acceptance
A brief description of the sampleWB91 Downey off ramp The quantity of what the sample constitutes200 cy
From where was the sample collectedJob Site First name of sampler or witnessed bySopheak
Last name of sampler or witnessed byChong Title of samplerTE
Telephone number of sampler12138170174 Laboratory sample identification21-2889
Linked DIME Sample ID The fabricator/manufacturer/facility namePeterson Chase
Transportation Laboratory (TL) Number Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier21-2889 Structure nameWB91 Downey off ramp
Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design numberCTS-65-EHI
The truck number from where the sample was collected10 The batch plant ticket number from where the sample was collectedNA
Concrete batch plantSHORT LOAD CONCRETE INC The fabricator/manufacturer designation for the samplePeterson Chase
A detailed description of where the material sample was collectedWB91 Downey off ramp Where the material sample would have been placed if not sampledSHORT LOAD CONCRETE INC
From Lot No.NA Bag Lot No.NA

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedDate AddedVerified?Release DateTest CommentsPrivacy LevelActions
2021-12-04-4-1CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength ConcreteSopheak Chong, CT D07 - Materials Field Laboratory, Unit 195312/07/2021
No

Sample File Attachments

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Test File Attachments


DIME Test ID: 2021-12-04-4-1 CTM 524-March 2013