Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2022-10-29-4
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 993771 DEA: 07325204 EFIS: 0716000082 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-210-R36.7/R37.1 |
| Award Date | 02/15/2022 |
| Closeout Date | 01/29/2024 |
| Work Description | San Gabriel River Bridge - CM/GC Project - Hinge And Diaphragm Repairs |
| Location Description | Los Angeles County - LOS ANGELES COUNTY IN IRWINDALE FROM 0.2 MILE EAST OF 0.7 MILE WEST OF IRWINDALE AVENUE OVECROSSING |
| QA Service Level | 1 (Verified on 04/21/2022) |
Sample Information
| Sample Taken Date | 10/29/2022 | Sample Unique Key | 4 |
|---|---|---|---|
| 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 | 10/31/2022 |
| Sample type | Department Acceptance | A brief description of the sample | 4x8 PCC cylinder |
| The quantity of what the sample constitutes | 130 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Samar | Last name of sampler or witnessed by | Saad |
| Title of sampler | Assistant Structure Representative | Telephone number of sampler | |
| Laboratory sample identification | 07-0339 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | National Ready Mix | Transportation Laboratory (TL) Number | 07-325204-005 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | S72500 |
|---|---|---|---|
| The truck number from where the sample was collected | 20121 | The batch plant ticket number from where the sample was collected | 647025 |
| Concrete batch plant | National Ready Mix | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | truck chute | 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: 2022-10-29-4-1 CTM 521-June 2020 (Verified)