Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2021-12-10-20
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Project Information
| Project Identifiers | Project ID: 215456 DEA: 07293604 EFIS: 0713000238 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-405-14.3/15.8 |
| Award Date | 05/26/2021 |
| Closeout Date | Not set |
| Work Description | CONSTRUCT AUXILIARY LANE AND WIDEN ON AND OFF RAMPS. |
| Location Description | LOS ANGELES COUNTY IN TORRANCE BETWEEN WESTERN AVENUE UNDERCROSSING AND WEST 182ND STREET |
| QA Service Level | 1 (Verified on 07/07/2021) |
Sample Information
| Sample Taken Date | 12/10/2021 | Sample Unique Key | 20 |
|---|---|---|---|
| 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 | 12/13/2021 |
| Sample type | Department Acceptance | A brief description of the sample | PCC cylinders |
| The quantity of what the sample constitutes | 130 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | John | Last name of sampler or witnessed by | Ajeakwa |
| Title of sampler | TEC ASR | Telephone number of sampler | |
| Laboratory sample identification | 21-0462 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | AA | Transportation Laboratory (TL) Number | 145616 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | 556300DH |
|---|---|---|---|
| The truck number from where the sample was collected | NA | The batch plant ticket number from where the sample was collected | NA |
| Concrete batch plant | AA | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | CHUTE FROM 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: 2021-12-10-20-1 CTM 521-June 2020 (Verified)