Sample Record

Owner Lab

  • CT D07 - Plant Services, Unit 1841

DIME Sample ID 2022-01-06-55

Project Information

Project IdentifiersProject ID: 214573
DEA: 073096U4
EFIS: 0719000091
DIST-CO-RTE-PM07-LA-210-R0.0/R9.7
Award Date04/03/2020
Closeout Date06/06/2024
Work DescriptionPLACE CONCRETE PAVEMENT, BARRIER, HMA, DRAINAGE, AND ELECTRICAL.
Location DescriptionLOS ANGELES COUNTY IN LOS ANGELES FROM INTERSTATE 5 TO WHEATLAND AVENUE UNDERCROSSING
QA Service Level1 (Verified on 06/05/2020)

Sample Information

Sample Taken Date01/06/2022 Sample Unique Key55
Date that the sample was received by the laboratory/organization performing the testing01/06/2022 Sample typeQuality Assurance
A brief description of the sample1 x 4 PCC Aggregate The quantity of what the sample constitutes250
From where was the sample collectedFabricator First name of sampler or witnessed byGERARDO
Last name of sampler or witnessed byZUBIETA Title of samplerTransportation Engineer
Telephone number of sampler2137924795 Laboratory sample identificationC-924023
Linked DIME Sample ID The fabricator/manufacturer/facility nameFlat Iron
Transportation Laboratory (TL) Number5554 Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier Structure name
Bid ItemNot set

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-19-0023::DURBIN
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedstock pile
Where the material sample would have been placed if not sampledPCC SLAB Primary Aggregate Nominal Size1 inch
The concrete mix design numberFWI 3018-A1 Lot number
Sublot number Aggregate Mix NumberNot set

Submitted Tests

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