Sample Record

Owner Lab

  • Kleinfelder, Incorporated - Los Angeles

DIME Sample ID 2022-01-29-10

Project Information

Project IdentifiersProject ID: 214524
DEA: 07304504
EFIS: 0714000067
DIST-CO-RTE-PM07-LA-57-R0.0/R4.5
Award Date06/11/2020
Closeout Date04/03/2025
Work DescriptionCONCRETE PAVEMENT, CONCRETE BARRIER, AND ELECTRICAL WORK.
Location DescriptionLOS ANGELES COUNTY IN DIAMOND BAR AND CITY OF INDUSTRY FROM ORANGE COUNTY LINE TO ROUTE 57/60 SEPARATION
QA Service Level1 (Verified on 08/12/2020)

Sample Information

Sample Taken Date01/29/2022 Sample Unique Key10
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 testing01/29/2022
Sample typePer Request A brief description of the sampleA set of 2 LCB RS cylinders
The quantity of what the sample constitutesPer 500 CY From where was the sample collectedJob Site
First name of sampler or witnessed byManuel Last name of sampler or witnessed byUy
Title of samplerField Materials Tester Telephone number of sampler9495016042
Laboratory sample identification22-0152 Linked DIME Sample ID
The fabricator/manufacturer/facility nameVanguard at the 57 Freeway Transportation Laboratory (TL) Number
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 numberHE4X4B
The truck number from where the sample was collectedLoad 1 The batch plant ticket number from where the sample was collected9498
Concrete batch plantVanguard at 57 Freeway The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedSee Below Notes Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

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