Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2022-06-22-26
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 213707 DEA: 081C38U4 EFIS: 0817000196 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-10-6.7/R25.1 |
| Award Date | 11/26/2019 |
| Closeout Date | 11/01/2023 |
| Work Description | Remove concrete pavement and base, and place HMA and JPCP |
| Location Description | ROUTE 10/60 SEPARATION IN BEAUMONT TO ROUTE 10/111 SEPARATION NEAR CABAZON. |
| QA Service Level | 1 (Verified on 01/09/2020) |
Sample Information
| Sample Taken Date | 06/22/2022 | Sample Unique Key | 26 |
|---|---|---|---|
| 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 | 06/24/2022 |
| Sample type | Quality Assurance | A brief description of the sample | 6x12 |
| The quantity of what the sample constitutes | 6` | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Zacharia | Last name of sampler or witnessed by | Roush |
| Title of sampler | QA Inspector | Telephone number of sampler | |
| Laboratory sample identification | 1012-70RR | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | coffman | Transportation Laboratory (TL) Number | 70RR |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | 1906-17 |
|---|---|---|---|
| The truck number from where the sample was collected | 69 | The batch plant ticket number from where the sample was collected | 12 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Riv10-A Sta 6750 WB Lane 3 and 4 Near WB Highland Springs Off Ramp LOAD 12 | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Date Added | Verified? | Release Date | Test Comments | Privacy Level | Actions |
|---|---|---|---|---|---|---|---|---|---|
| No results found. | |||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||