Sample Record

Owner Lab

  • CT D07 - Materials Field Laboratory, Unit 1953

DIME Sample ID 2021-11-10-54

Project Information

Project IdentifiersProject ID: 211260
DEA: 072159U4
EFIS: 0715000160
DIST-CO-RTE-PM07-LA,ORA-5-0.0/1.5, 44.3/44.4
Award Date05/27/2016
Closeout Date08/01/2023
Work DescriptionCONSTRUCT HOV LANES AND MIX FLOW LANES.
Location DescriptionLOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
QA Service Level1 (Verified on 03/16/2016)

Sample Information

Sample Taken Date11/10/2021 Sample Unique Key54
Date that the sample was received by the laboratory/organization performing the testing12/22/2021 Sample typeDepartment Acceptance
A brief description of the samplePCC cylinders The quantity of what the sample constitutes45
From where was the sample collectedJob Site First name of sampler or witnessed byAntonio
Last name of sampler or witnessed byPicazo Title of samplerTEC ASR
Telephone number of sampler Laboratory sample identification21-0434
Linked DIME Sample ID The fabricator/manufacturer/facility nameSecurity Paving batch plant
Transportation Laboratory (TL) Number21111901 Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier Structure name
Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design numberG3-17-STR-006F
The truck number from where the sample was collected5 The batch plant ticket number from where the sample was collectedNA
Concrete batch plantSecurity Paving The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedChute Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

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