Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2015-03-11-4

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 Date03/11/2015 Sample Unique Key4
Date that the sample was received by the laboratory/organization performing the testing03/16/2015 Sample typeQuality Control
A brief description of the sample6x12 concrete cylinders The quantity of what the sample constitutes2
From where was the sample collectedJob Site First name of sampler or witnessed byHarold
Last name of sampler or witnessed byFrench Title of samplerASR
Telephone number of samplerUnknown Laboratory sample identificationUnknown
Linked DIME Sample IDUnknown The fabricator/manufacturer/facility nameRT5
Transportation Laboratory (TL) Number150316B Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown
Structure unique identifierUnknown Structure nameUnknown
Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design numberS62578
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collected176662
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedStem Pour RW 1605 Where the material sample would have been placed if not sampledNot set
From Lot No.Not set Bag Lot No.Not set

Submitted Tests

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