Sample Record

Owner Lab

  • CT D07 - Materials Field Laboratory, Unit 1953

DIME Sample ID 2021-12-09-8

Project Information

Project IdentifiersProject ID: 7613
DEA: 071218W4
EFIS: 0700021119
DIST-CO-RTE-PM07-LA-5-29.4/31.6
Award Date11/29/2012
Closeout Date07/31/2023
Work DescriptionREALIGN ROUTE 5 AND RAILROAD TRACKS AND RECONFIGURE ON- AND OFF-RAMPS.
Location DescriptionLOS ANGELES COUNTY IN BURBANK FROM WEST MAGNOLIA BOULEVARD OVERCROSSING TO 0.3 MILE NORTH OF BUENA VISTA STREET/WINONA AVENUE UNDERCROSSING
QA Service Level1 (Verified on 10/08/2012)

Sample Information

Sample Taken Date12/09/2021 Sample Unique Key8
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 testing12/09/2021
Sample typeDepartment Acceptance A brief description of the sampleSB5 mainline A line sta.1552+20-1561+40
The quantity of what the sample constitutes520 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 identification21-2939 Linked DIME Sample ID
The fabricator/manufacturer/facility nameSecurity Paving company Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier21-2939
Structure nameSB5 mainline A line

Material Information

Material TypeConcrete The concrete mix design numberG3-16-PCC-002
The truck number from where the sample was collected15 The batch plant ticket number from where the sample was collected224306
Concrete batch plantSecurity Paving Burbank Batch Plant The fabricator/manufacturer designation for the sampleSECURITY PAVING
A detailed description of where the material sample was collectedJobsite Where the material sample would have been placed if not sampledjobsite
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-12-09-8-1CTM 523-May 2020: Method of Test for Flexural Strength of ConcreteSopheak Chong, CT D07 - Materials Field Laboratory, Unit 195301/06/2022Sopheak Chong
No
Info

Sample File Attachments

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Test File Attachments


DIME Test ID: 2021-12-09-8-1 CTM 523-May 2020