Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2015-07-01-3
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 208642 DEA: 07252004 EFIS: 0712000074 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-405-39.4/48.6 |
| Award Date | 06/28/2013 |
| Closeout Date | 08/25/2016 |
| Work Description | REPLACE CONC PAVEMENT WITH PRECAST PRESTRESSED CONC PAVEMENT. |
| Location Description | LOS ANGELES COUNTY IN LOS ANGELES FROM ROUTE 405/101 SEPARATION TO ROUTE 405/5 SEPARATION |
| QA Service Level | 1 (Verified on 08/13/2013) |
Sample Information
| Sample Taken Date | 07/01/2015 | 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 | 07/07/2015 |
| Sample type | Quality Assurance | A brief description of the sample | Concrete Cylinder 6 x 12 |
| The quantity of what the sample constitutes | 6 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Addis | Last name of sampler or witnessed by | Ambaye |
| Title of sampler | Structure Representative | Telephone number of sampler | Unknown |
| Laboratory sample identification | 910-01 | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | Associate Ready Mix | Transportation Laboratory (TL) Number | 150701 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | Unknown |
| Structure name | Austin Vault Slab and RW | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | 557237 |
|---|---|---|---|
| The truck number from where the sample was collected | 2 | 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 | TRUCK | Where the material sample would have been placed if not sampled | Slab and RW |
| 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: 2015-07-01-3-1 CTM 521-November 2014 (Verified)
DIME Test ID: 2015-07-01-3-2 CTM 521-November 2014 (Verified)