Sample Record
Owner Lab
- Kleinfelder, Incorporated - Los Angeles
DIME Sample ID 2022-07-08-3
Project Information
| Project Identifiers | Project ID: 215221 DEA: 07332604 EFIS: 0716000287 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-10-R12.4/14.9 |
| Award Date | 12/16/2020 |
| Closeout Date | 11/25/2024 |
| Work Description | REMOVE RAISED ISLAND, CONSTRUCT CONCRETE BARRIER AND INSTALL LIGHTING. |
| Location Description | THE COUNTY AND CITY OF LOS ANGELES FROM 0.1 MILE EAST OF ARLINGTON AVENUE OVERCROSSING TO 0.7 MILE EAST OF ROUTE 10/110 SEPARATION |
| QA Service Level | 1 (Verified on 03/19/2021) |
Sample Information
| Sample Taken Date | 07/08/2022 | Sample Unique Key | 3 |
|---|---|---|---|
| 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 | 07/08/2022 |
| Sample type | Quality Assurance | A brief description of the sample | A set of 2 LCB cylinders |
| The quantity of what the sample constitutes | 250 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Manuel | Last name of sampler or witnessed by | Uy |
| Title of sampler | Field Materials Tester | Telephone number of sampler | 9495016042 |
| Laboratory sample identification | 22-1658 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Robertsons Gardena | Transportation Laboratory (TL) Number | |
| 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 | SC270N31 |
|---|---|---|---|
| The truck number from where the sample was collected | Load 3 | The batch plant ticket number from where the sample was collected | 6824650 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Concrete from wheelbarrow | Where the material sample would have been placed if not sampled | |
| 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: 2022-07-08-3-1 CTM 521-June 2020 (Verified)
