Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2022-04-02-15
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214671 DEA: 07303904 EFIS: 0714000044 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-10-31.2/37.2 |
| Award Date | 11/25/2020 |
| Closeout Date | 10/11/2023 |
| Work Description | LANE REPLACEMENT |
| Location Description | LOS ANGELES COUNTY IN BALDWIN PARK AND WEST COVINA FROM 0.1 MILE EAST OF THE 10/605 SEPARATION TO 0.3 MILE WEST OF CITRUS STREET OVERCROSSING |
| QA Service Level | 1 (Verified on 01/21/2021) |
Sample Information
| Sample Taken Date | 04/02/2022 | Sample Unique Key | 15 |
|---|---|---|---|
| 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 | 04/02/2022 |
| Sample type | Department Acceptance | A brief description of the sample | 6"x12" LCBRS cylinder |
| The quantity of what the sample constitutes | 500 cubic yards | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | George | Last name of sampler or witnessed by | Zacarias |
| Title of sampler | G3 Quality Technician | Telephone number of sampler | |
| Laboratory sample identification | 22-0628 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Security Paving batch plant | Transportation Laboratory (TL) Number | 22-0628 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | G3-22LRS-271R |
|---|---|---|---|
| The truck number from where the sample was collected | 1987 | The batch plant ticket number from where the sample was collected | 235421 |
| Concrete batch plant | Security Paving Durbin | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | Discharge from concrete truck into wheelbarrow. | Where the material sample would have been placed if not sampled | NA |
| 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: 2022-04-02-15-1 CTM 521-June 2020 (Verified)