Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2015-03-20-3
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 209019 DEA: 071952U4 EFIS: 0700000201 |
|---|---|
| DIST-CO-RTE-PM | 07-VEN-23,101-3.3/3.8,R0.1/R4.5 |
| Award Date | 11/21/2013 |
| Closeout Date | 06/25/2019 |
| Work Description | WIDEN FREEWAY AND RAMPS AND RECONSTRUCT MEDIAN. |
| Location Description | VENTURA COUNTY IN THOUSAND OAKS ON ROUTE 101 FROM 0.6 MILE SOUTH OF WESTLAKE BOULEVARD OVERCROSSING TO 0.4 MILE NORTH OF MOORPARK ROAD UNDERCROSSING AND ON ROUTE 23 FROM ROUTE 101 TO 0.1 MILE NORTH OF HILLCREST DRIVE UNDERCROSSING |
| QA Service Level | 1 (Verified on 08/13/2013) |
Sample Information
| Sample Taken Date | 03/20/2015 | 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 | 03/25/2015 |
| Sample type | Quality Control | A brief description of the sample | 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 6 cylinders | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | A | Last name of sampler or witnessed by | MOGHSOUDLU |
| Title of sampler | ASR | Telephone number of sampler | Unknown |
| Laboratory sample identification | 876-15 | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | Collected at jobsite | Transportation Laboratory (TL) Number | 106615 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | Unknown |
| Structure name | NOT PROVIDED |
Material Information
| Material Type | Concrete | The concrete mix design number | NOT PROVIDED |
|---|---|---|---|
| The truck number from where the sample was collected | Unknown | The batch plant ticket number from where the sample was collected | NOT PROVIDED |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| A detailed description of where the material sample was collected | from mix truck | Where the material sample would have been placed if not sampled | Not set |
| From Lot No. | Not set | Bag Lot No. | Not set |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2015-03-20-3-1 CTM 521-November 2014 (Verified)